Provider Demographics
NPI:1962663591
Name:DORSEY, WILLIAM GERARD (LCSW)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:GERARD
Last Name:DORSEY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 BICENTENNIAL WAY
Mailing Address - Street 2:KAISER PERMANENTE PALLIATIVE CARE
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-2149
Mailing Address - Country:US
Mailing Address - Phone:707-393-4480
Mailing Address - Fax:707-393-3498
Practice Address - Street 1:401 BICENTENNIAL WAY
Practice Address - Street 2:KAISER PERMANENTE PALLIATIVE CARE
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-2149
Practice Address - Country:US
Practice Address - Phone:707-393-4480
Practice Address - Fax:707-393-3498
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 107091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical