Provider Demographics
NPI:1477600674
Name:DORN, WILLIAM RAYMOND (LPC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:RAYMOND
Last Name:DORN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4721 MCKNIGHT RD
Mailing Address - Street 2:SUITE 218 S
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-3415
Mailing Address - Country:US
Mailing Address - Phone:412-369-4285
Mailing Address - Fax:412-939-0246
Practice Address - Street 1:4721 MCKNIGHT RD
Practice Address - Street 2:SUITE 218 S
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-3415
Practice Address - Country:US
Practice Address - Phone:412-369-4285
Practice Address - Fax:412-939-0246
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000184101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional