Provider Demographics
NPI:1811597727
Name:HOWARD, DORSEY MATTHEW (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DORSEY
Middle Name:MATTHEW
Last Name:HOWARD
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 33RD AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-3941
Mailing Address - Country:US
Mailing Address - Phone:717-877-2850
Mailing Address - Fax:
Practice Address - Street 1:315 33RD AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-3941
Practice Address - Country:US
Practice Address - Phone:717-877-2850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3716103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical