Provider Demographics
NPI:1609386077
Name:DOROTHY HOPKINS LLC
Entity Type:Organization
Organization Name:DOROTHY HOPKINS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMHC
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:863-648-0313
Mailing Address - Street 1:5130 S FLORIDA AVE STE 408
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2539
Mailing Address - Country:US
Mailing Address - Phone:863-648-0313
Mailing Address - Fax:
Practice Address - Street 1:5130 S FLORIDA AVE STE 408
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2539
Practice Address - Country:US
Practice Address - Phone:863-648-0313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14501261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)