Provider Demographics
NPI:1427003912
Name:ORNER, MARC M (PH D)
Entity Type:Individual
Prefix:MR
First Name:MARC
Middle Name:M
Last Name:ORNER
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:MR
Other - First Name:MARC
Other - Middle Name:
Other - Last Name:ORNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PH D
Mailing Address - Street 1:3444 N 1ST ST STE 401
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79603-6940
Mailing Address - Country:US
Mailing Address - Phone:325-690-1313
Mailing Address - Fax:325-690-1383
Practice Address - Street 1:3444 N 1ST ST STE 401
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79603-6940
Practice Address - Country:US
Practice Address - Phone:325-690-1313
Practice Address - Fax:325-690-1383
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2019-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX828106H00000X
TX2073101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX025795801Medicaid
TX1003LCOtherBCBS