Healthcare Provider Details

I. General information

NPI: 1447580154
Provider Name (Legal Business Name): DORIAN LISA HEAD MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2009
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 LINDSLEY DR STE 300
MORRISTOWN NJ
07960-4456
US

IV. Provider business mailing address

25 LINDSLEY DR STE 300
MORRISTOWN NJ
07960-4456
US

V. Phone/Fax

Practice location:
  • Phone: 973-998-7900
  • Fax: 973-998-7910
Mailing address:
  • Phone: 973-998-7900
  • Fax: 973-998-7910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00505500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: