Provider Demographics
NPI:1104592989
Name:HURLEY-WELLJAMS-DOROF, WILLIAM MAX (PSYD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MAX
Last Name:HURLEY-WELLJAMS-DOROF
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 U ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-7991
Mailing Address - Country:US
Mailing Address - Phone:202-888-5595
Mailing Address - Fax:
Practice Address - Street 1:1330 U ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-7991
Practice Address - Country:US
Practice Address - Phone:202-888-5595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-20
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY200001501103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical