Provider Demographics
NPI:1508013251
Name:DORELIEN, STANLEY (LPC)
Entity type:Individual
Prefix:MR
First Name:STANLEY
Middle Name:
Last Name:DORELIEN
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 1:2055 SUGARLOAF CIR STE 575
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-9804
Mailing Address - Country:US
Mailing Address - Phone:347-615-3239
Mailing Address - Fax:
Practice Address - Street 1:2055 SUGARLOAF CIR STE 575
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-9804
Practice Address - Country:US
Practice Address - Phone:404-999-7971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC014452101YP2500X
GAAPC006878101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional