Provider Demographics
NPI:1588068258
Name:DORSETT, MELISSA KAY
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:KAY
Last Name:DORSETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101 LISTER AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64130-3156
Mailing Address - Country:US
Mailing Address - Phone:316-393-7409
Mailing Address - Fax:
Practice Address - Street 1:4601 COLLEGE BLVD STE 275
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1678
Practice Address - Country:US
Practice Address - Phone:816-774-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-09
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS47341041C0700X
KS8844104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical