Provider Demographics
NPI:1245896083
Name:DORCEUS PIERRE, KETHIA
Entity type:Individual
Prefix:
First Name:KETHIA
Middle Name:
Last Name:DORCEUS PIERRE
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 1:5518 ARNOLD PALMER DR APT 1226
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-1931
Mailing Address - Country:US
Mailing Address - Phone:407-300-2846
Mailing Address - Fax:
Practice Address - Street 1:3077 N MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-1735
Practice Address - Country:US
Practice Address - Phone:910-275-5766
Practice Address - Fax:866-990-0668
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-16
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0194241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical