Provider Demographics
NPI:1639239601
Name:MORY, WILLIAM P (LPC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:P
Last Name:MORY
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 1:211 N FANNIN AVE
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-3118
Mailing Address - Country:US
Mailing Address - Phone:903-624-3960
Mailing Address - Fax:800-906-1038
Practice Address - Street 1:211 N FANNIN AVE
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-3118
Practice Address - Country:US
Practice Address - Phone:903-624-3960
Practice Address - Fax:800-906-1038
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10746101YP2500X, 101YM0800X
TX1640106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0260903-03Medicaid
TX2501LCOtherBLUE CROSS BLUE SHIELD