Provider Demographics
NPI:1861145088
Name:DORRIS, EMILY NICOLE (PLPC, NCC)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:NICOLE
Last Name:DORRIS
Suffix:
Gender:F
Credentials:PLPC, NCC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:NICOLE
Other - Last Name:HEINLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:760 PLANTATION BLVD
Mailing Address - Street 2:
Mailing Address - City:SIKESTON
Mailing Address - State:MO
Mailing Address - Zip Code:63801-5736
Mailing Address - Country:US
Mailing Address - Phone:573-471-0800
Mailing Address - Fax:
Practice Address - Street 1:760 PLANTATION BLVD
Practice Address - Street 2:
Practice Address - City:SIKESTON
Practice Address - State:MO
Practice Address - Zip Code:63801-5736
Practice Address - Country:US
Practice Address - Phone:573-471-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021041665101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health