Provider Demographics
NPI:1487452025
Name:RORY WALL COUNSELING, LLC
Entity type:Organization
Organization Name:RORY WALL COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:WALL
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC-C
Authorized Official - Phone:215-873-4598
Mailing Address - Street 1:104 HEAD TIDE RD
Mailing Address - Street 2:
Mailing Address - City:ALNA
Mailing Address - State:ME
Mailing Address - Zip Code:04535-3014
Mailing Address - Country:US
Mailing Address - Phone:215-873-4598
Mailing Address - Fax:
Practice Address - Street 1:42 FRONT ST
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:ME
Practice Address - Zip Code:04530-2375
Practice Address - Country:US
Practice Address - Phone:215-873-4598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty