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Individual

MS. DORETHA MICHELE MCBRIDE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW, CADC

Contact information

Practice address
509 MILLIFIORA LN, KISSIMMEE, FL 34759-4336
(219) 226-5567
(863) 496-5338
Mailing address
509 MILLIFIORA LN, KISSIMMEE, FL 34759-4336
(219) 226-5567
(863) 496-5338

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
22796
IL
1041C0700X
Clinical Social Worker
149.015775
IL
1041C0700X
Clinical Social Worker
34007000A
IN
1041C0700X
Clinical Social Worker
Primary
SW16933
FL

Other

Enumeration date
09/11/2013
Last updated
06/04/2020
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