Individual provider Active NPI

Brandolyn Dortch, LPC

  • Mental Health Counselor
  • Mobile, AL
National Provider Identifier
1003695966
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC05037 Issued in AL
Practice address
5750A Southland Dr
Mobile, AL 36693-3316
Phone
(251) 450-2211
NPI assigned
Sep 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC05037 AL Primary

Addresses

Primary practice location

5750A Southland Dr
Mobile, AL 36693-3316

Mailing address

5750A Southland Dr
Mobile, AL 36693-3316
Phone (251) 450-2211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240229002041 AL Practitioner - Mental Health Counselor 8426493412 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC05037ALMDMental Health Counselor

Networks

  • devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
  • MS PPO C-SNP
  • TN PPO
  • AL HMO
  • devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
  • devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
  • AL HMO D-SNP
  • FL PPO
  • TN PPO C-SNP
  • FL HMO D-SNP
  • MS PPO
  • devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
  • MS PPO D-SNP
  • devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1003695966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750A SOUTHLAND DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366933316",
            "telephone_number": "251-450-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750A SOUTHLAND DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366933316",
            "telephone_number": "251-450-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORTCH",
        "first_name": "BRANDOLYN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-28",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AL",
            "license": "LPC05037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.