Provider Demographics
NPI:1124327192
Name:DORSEY, LAKEISHA SHANEE (LISW-S, PSYS)
Entity type:Individual
Prefix:MRS
First Name:LAKEISHA
Middle Name:SHANEE
Last Name:DORSEY
Suffix:
Gender:F
Credentials:LISW-S, PSYS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17325 EUCLID AVE STE 2003
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-1273
Mailing Address - Country:US
Mailing Address - Phone:216-772-0229
Mailing Address - Fax:
Practice Address - Street 1:17325 EUCLID AVE STE 2003
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-1273
Practice Address - Country:US
Practice Address - Phone:216-772-0229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-16
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH103TS0200X
OHI.21025511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool