Provider Demographics
NPI:1538102330
Name:DORNAUS, DEBORAH P (M A,LCPC)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:P
Last Name:DORNAUS
Suffix:
Gender:F
Credentials:M A,LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7820 N UNIVERSITY ST
Mailing Address - Street 2:STE.207
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-1220
Mailing Address - Country:US
Mailing Address - Phone:309-693-0038
Mailing Address - Fax:309-693-0112
Practice Address - Street 1:7820 N UNIVERSITY ST
Practice Address - Street 2:STE.207
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-1220
Practice Address - Country:US
Practice Address - Phone:309-693-0038
Practice Address - Fax:309-693-0112
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional