Provider Demographics
NPI:1972744092
Name:DORRIS, VICKI MARIE (MS, LMHP, PLADC,NCC)
Entity Type:Individual
Prefix:MS
First Name:VICKI
Middle Name:MARIE
Last Name:DORRIS
Suffix:
Gender:F
Credentials:MS, LMHP, PLADC,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5851 N 90TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-1856
Mailing Address - Country:US
Mailing Address - Phone:402-934-1225
Mailing Address - Fax:
Practice Address - Street 1:5851 N 90TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-1856
Practice Address - Country:US
Practice Address - Phone:402-504-1736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-19
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8831101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health