Provider Demographics
NPI:1740349398
Name:ORTON, GERALDINE LOUISE (LPC)
Entity type:Individual
Prefix:DR
First Name:GERALDINE
Middle Name:LOUISE
Last Name:ORTON
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 1:8515 GULF RD
Mailing Address - Street 2:
Mailing Address - City:NORTH EAST
Mailing Address - State:PA
Mailing Address - Zip Code:16428-4311
Mailing Address - Country:US
Mailing Address - Phone:814-725-3636
Mailing Address - Fax:
Practice Address - Street 1:2700 WEST TWENTY-FIRST STREET SUITE 3
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506
Practice Address - Country:US
Practice Address - Phone:814-490-4235
Practice Address - Fax:814-725-3636
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003772101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001809776OtherBLUE CROSS- BLUE SHIELD