Provider Demographics
NPI:1427735372
Name:PRINCE, DOROTHY CLAIRE (LCSW)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:CLAIRE
Last Name:PRINCE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2039 COWDEN AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-5322
Mailing Address - Country:US
Mailing Address - Phone:901-833-5696
Mailing Address - Fax:
Practice Address - Street 1:575 PHELAN AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38126-4005
Practice Address - Country:US
Practice Address - Phone:901-686-1581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical