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NPI Code Detail

MEDICARE: RYAN JEFFREY DALLATORE LPC

MEDICARE:   RYAN JEFFREY DALLATORE  LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorPC009282PA
2101YP2500XProfessional Counselor2298WV

General Provider Information

NPI Number : 1043752744
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN JEFFREY DALLATORE LPC
Provider Business Mailing Address
First Line : 652 MADIGAN AVE
Second Line :
City : MORGANTOWN
State : WV
Zip : 26501-6716
Country : US
Telephone Number : 304-777-8227
Fax Number :
Provider Business Practice Location Address
First Line : 652 MADIGAN AVE
Second Line :
City : MORGANTOWN
State : WV
Zip : 26501-6716
Country : US
Telephone Number : 304-777-8227
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2016
Last Update Date : 02/05/2026

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Directions to “ RYAN JEFFREY DALLATORE LPC” Practice Location

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