Provider Demographics
NPI:1336839950
Name:WELCH, TORI K
Entity type:Individual
Prefix:
First Name:TORI
Middle Name:K
Last Name:WELCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TORI
Other - Middle Name:K
Other - Last Name:ST JOHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 HEMLOCK FARMS RD STE 8
Mailing Address - Street 2:
Mailing Address - City:LORDS VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18428-6133
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:110 HEMLOCK FARMS RD STE 8
Practice Address - Street 2:
Practice Address - City:LORDS VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18428-6133
Practice Address - Country:US
Practice Address - Phone:570-290-8603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2025-10-21
Deactivation Date:2024-04-16
Deactivation Code:
Reactivation Date:2024-07-18
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
PAPC018975101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health