Provider Demographics
NPI:1902306905
Name:DOREMUS, JOCELYN (LMFT)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:DOREMUS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 670813
Mailing Address - Street 2:
Mailing Address - City:CHUGIAK
Mailing Address - State:AK
Mailing Address - Zip Code:99567-0813
Mailing Address - Country:US
Mailing Address - Phone:907-726-3572
Mailing Address - Fax:
Practice Address - Street 1:23554 BLUE SKIES DR
Practice Address - Street 2:
Practice Address - City:CHUGIAK
Practice Address - State:AK
Practice Address - Zip Code:99567-5640
Practice Address - Country:US
Practice Address - Phone:907-726-3572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY262927106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist