Healthcare Provider Details

I. General information

NPI: 1932929205
Provider Name (Legal Business Name): WILLIAM DEVORICK LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2024
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 WINDMILL WAY
LITITZ PA
17543-8062
US

IV. Provider business mailing address

315 WINDMILL WAY
LITITZ PA
17543-8062
US

V. Phone/Fax

Practice location:
  • Phone: 717-419-1847
  • Fax:
Mailing address:
  • Phone: 717-419-1847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC017703
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: