Basic Information
| Provider Information | |||||||||
| NPI: | 1528519774 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DORSEY | ||||||||
| FirstName: | D'JUAN | ||||||||
| MiddleName: | TERRENCE | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | SR. | ||||||||
| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1010 COMMON ST | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701122401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5043021323 | ||||||||
| FaxNumber: | 5043244573 | ||||||||
| Practice Location | |||||||||
| Address1: | 1010 COMMON ST | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701122401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5043021323 | ||||||||
| FaxNumber: | 5043244573 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/21/2016 | ||||||||
| LastUpdateDate: | 10/21/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 8833 | LA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.