Healthcare Provider Details
I. General information
NPI: 1023243185
Provider Name (Legal Business Name): DOROTHY ANN DEAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/19/2009
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1035 BEECH ST
SCRANTON PA
18505-2523
US
IV. Provider business mailing address
1035 BEECH ST
SCRANTON PA
18505-2523
US
V. Phone/Fax
- Phone: 570-445-0258
- Fax:
- Phone: 570-445-0258
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | PC003056 |
| License Number State | PA |
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: