Provider Demographics
NPI:1023819398
Name:SPIVEY, DORIS
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:SPIVEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 STAFFORDSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-4237
Mailing Address - Country:US
Mailing Address - Phone:757-215-8503
Mailing Address - Fax:757-215-8503
Practice Address - Street 1:4505 STAFFORDSHIRE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-4237
Practice Address - Country:US
Practice Address - Phone:757-215-8503
Practice Address - Fax:757-215-8503
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-22
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0203541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical