Individual
TYEASIA K DORSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSAC, LCAS
Contact information
Practice address
201 E PITT ST STE 103, TARBORO, NC 27886-5137
(252) 378-9940
Mailing address
2054 FISHPOND RD, GREENVILLE, NC 27834-8852
(252) 814-5095
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
14234
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
21899
NC
103TP2701X
Group Psychotherapy Psychologist
21899
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00586698
—
NC
Enumeration date
07/11/2019
Last updated
02/26/2023
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