Provider Demographics
NPI:1891267787
Name:DORN, ALICIA (LCPC, LPCC)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:
Last Name:DORN
Suffix:
Gender:F
Credentials:LCPC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7201 METRO BLVD STE 550
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55439-1353
Mailing Address - Country:US
Mailing Address - Phone:443-977-4885
Mailing Address - Fax:
Practice Address - Street 1:10621 165TH ST W
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-3520
Practice Address - Country:US
Practice Address - Phone:763-210-9966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-18
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC8143101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional