Provider Demographics
NPI:1346264199
Name:DORAN, JAMES PETER (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:PETER
Last Name:DORAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10106 KRAUSE RD
Mailing Address - Street 2:SUITE 100C
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-6572
Mailing Address - Country:US
Mailing Address - Phone:804-751-0277
Mailing Address - Fax:804-751-9086
Practice Address - Street 1:10106 KRAUSE RD
Practice Address - Street 2:SUITE 100C
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-6572
Practice Address - Country:US
Practice Address - Phone:804-751-0277
Practice Address - Fax:804-751-9086
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040002881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10607OtherCIGNA BEHAVIORAL HEALTH
VA094949OtherANTHEM BLUE CROSS/ BLUE S