Provider Demographics
NPI:1275126856
Name:DORSAINVIL, MONDY (MSW)
Entity Type:Individual
Prefix:MR
First Name:MONDY
Middle Name:
Last Name:DORSAINVIL
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6241 FARNSWORTH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149-3534
Mailing Address - Country:US
Mailing Address - Phone:610-203-0048
Mailing Address - Fax:
Practice Address - Street 1:6241 FARNSWORTH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19149-3534
Practice Address - Country:US
Practice Address - Phone:610-203-0048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling