Provider Demographics
NPI:1922576099
Name:DORMAN, PAULA (LCSW)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:DORMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3124 WAYNE RD
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-2666
Mailing Address - Country:US
Mailing Address - Phone:571-438-3498
Mailing Address - Fax:
Practice Address - Street 1:3124 WAYNE RD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-2666
Practice Address - Country:US
Practice Address - Phone:571-438-3498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALICSW1217671041C0700X
VA09040102141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical