Provider Demographics
NPI:1831576180
Name:ANDERSON, DOROTHY JEFFRIES (EDD, NCC, LMHC, LPC)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:JEFFRIES
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:EDD, NCC, LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 MARINA CV
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-9000
Mailing Address - Country:US
Mailing Address - Phone:253-576-2994
Mailing Address - Fax:
Practice Address - Street 1:18 MARINA CV
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-9000
Practice Address - Country:US
Practice Address - Phone:253-576-2994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-06
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS266101YP2500X
MS1973101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional