Provider Demographics
NPI:1477669000
Name:DELLARIA, DONNA (LPC)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:DELLARIA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 WEATHERSTONE DR
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1921
Mailing Address - Country:US
Mailing Address - Phone:484-401-1260
Mailing Address - Fax:
Practice Address - Street 1:303 WEATHERSTONE DR
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1921
Practice Address - Country:US
Practice Address - Phone:484-401-1260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2022-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX08579101Y00000X
TX18579101YP2500X
NJNJDCATEMP-023839101YP2500X
PAPC009534101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX174420601Medicaid