Provider Demographics
NPI:1679745228
Name:DONNELLY, LORRAINE (LPC)
Entity Type:Individual
Prefix:MS
First Name:LORRAINE
Middle Name:
Last Name:DONNELLY
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 1:11 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-5237
Mailing Address - Country:US
Mailing Address - Phone:610-323-5144
Mailing Address - Fax:610-326-6996
Practice Address - Street 1:11 W 8TH ST
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-5237
Practice Address - Country:US
Practice Address - Phone:610-323-5144
Practice Address - Fax:610-326-6996
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004297101YP2500X
PA91-013670101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool