Provider Demographics
NPI:1801968060
Name:PORAY, WILLIAM DOUGLAS (LCSW)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DOUGLAS
Last Name:PORAY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:JENKINS TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18640-1333
Mailing Address - Country:US
Mailing Address - Phone:570-301-3565
Mailing Address - Fax:
Practice Address - Street 1:1605 RIVER RD
Practice Address - Street 2:
Practice Address - City:JENKINS TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18640-1333
Practice Address - Country:US
Practice Address - Phone:570-301-3565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW008651L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical