Provider Demographics
NPI:1619490414
Name:SAKIL, DORETHA YVETTE (LCSWA)
Entity Type:Individual
Prefix:MRS
First Name:DORETHA
Middle Name:YVETTE
Last Name:SAKIL
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:MRS
Other - First Name:DORETHA
Other - Middle Name:
Other - Last Name:SOMERVILLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCASA
Mailing Address - Street 1:1933 ASHRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-2872
Mailing Address - Country:US
Mailing Address - Phone:804-550-8922
Mailing Address - Fax:
Practice Address - Street 1:1638 OWEN DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3424
Practice Address - Country:US
Practice Address - Phone:910-615-5957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-24
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-26208101YA0400X
NCP0118451041C0700X
NCP0166241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)