Provider Demographics
NPI:1144046186
Name:ORREGO, KENNETH (LAPC)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:
Last Name:ORREGO
Suffix:
Gender:M
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 BROOKSIDE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18106-9026
Mailing Address - Country:US
Mailing Address - Phone:484-268-2399
Mailing Address - Fax:
Practice Address - Street 1:1005 BROOKSIDE RD STE 105
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-9026
Practice Address - Country:US
Practice Address - Phone:484-268-2399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAPC000657101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor