Provider Demographics
NPI:1982884227
Name:DOPERAK, LAWRENCE (LP)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:DOPERAK
Suffix:
Gender:M
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4150 WASHINGTON RD
Mailing Address - Street 2:P.O. BOX 945
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2534
Mailing Address - Country:US
Mailing Address - Phone:724-941-1120
Mailing Address - Fax:724-941-0993
Practice Address - Street 1:4150 WASHINGTON RD
Practice Address - Street 2:SUITE 105
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2534
Practice Address - Country:US
Practice Address - Phone:724-941-1120
Practice Address - Fax:724-941-0993
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-04
Last Update Date:2007-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-002459-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist