Provider Demographics
NPI:1154890887
Name:DORSEY, BRANDI MICHELLE (LPC)
Entity type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:MICHELLE
Last Name:DORSEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6987 W WHEELER RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-5744
Mailing Address - Country:US
Mailing Address - Phone:479-799-7473
Mailing Address - Fax:888-375-4518
Practice Address - Street 1:3511 SILENT GROVE RD
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-7913
Practice Address - Country:US
Practice Address - Phone:479-799-7473
Practice Address - Fax:888-375-4518
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-26
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP2011097101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR258367719Medicaid
AR258367719Medicaid