Provider Demographics
NPI:1043787401
Name:DORSEY-DAVIS, TAMMY (LCSW)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:DORSEY-DAVIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:5692 CRIEVEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38135-1006
Mailing Address - Country:US
Mailing Address - Phone:901-384-8699
Mailing Address - Fax:
Practice Address - Street 1:5692 CRIEVEWOOD DR
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38135-1006
Practice Address - Country:US
Practice Address - Phone:901-384-8699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-24
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000060151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical