Provider Demographics
NPI:1053480582
Name:DORMAN, PATRICIA BARKER (LPC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:BARKER
Last Name:DORMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:ANNE
Other - Last Name:BARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 CAPITOLA DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-4496
Mailing Address - Country:US
Mailing Address - Phone:919-474-6400
Mailing Address - Fax:
Practice Address - Street 1:100 CAPITOLA DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-4496
Practice Address - Country:US
Practice Address - Phone:919-474-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC002904101YP2500X
NC10092101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional