Provider Demographics
NPI:1598765299
Name:DOBRZANSKI, JOANNE E (LPC, LSW)
Entity Type:Individual
Prefix:MISS
First Name:JOANNE
Middle Name:E
Last Name:DOBRZANSKI
Suffix:
Gender:F
Credentials:LPC, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 348
Mailing Address - Street 2:
Mailing Address - City:COLLIERS
Mailing Address - State:WV
Mailing Address - Zip Code:26035
Mailing Address - Country:US
Mailing Address - Phone:304-723-3423
Mailing Address - Fax:304-723-3426
Practice Address - Street 1:651 COLLIERS WAY
Practice Address - Street 2:SUITE 412
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062
Practice Address - Country:US
Practice Address - Phone:304-723-3423
Practice Address - Fax:304-723-3426
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV936101YM0800X
WVCP00450679104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV235532000OtherMAGELLAN
WVY276161OtherHEALTH PLAN
WV0023528001Medicaid
WV550583609050OtherBLUE CROSS/BLUE SHIELD
WVDOSW17122Medicare ID - Type Unspecified