Provider Demographics
NPI:1811324890
Name:ORNDORFF, JUSTIN (LPC)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:ORNDORFF
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 1:110 E MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:NORTH EAST
Mailing Address - State:PA
Mailing Address - Zip Code:16428-1333
Mailing Address - Country:US
Mailing Address - Phone:814-347-5018
Mailing Address - Fax:
Practice Address - Street 1:110 E MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:NORTH EAST
Practice Address - State:PA
Practice Address - Zip Code:16428-1333
Practice Address - Country:US
Practice Address - Phone:814-347-5018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-04
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007145101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional