Provider Demographics
NPI:1710912415
Name:DVORCHAK, TANYA (MS)
Entity type:Individual
Prefix:MS
First Name:TANYA
Middle Name:
Last Name:DVORCHAK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:TANYA
Other - Middle Name:
Other - Last Name:LIVESAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED
Mailing Address - Street 1:PO BOX 709
Mailing Address - Street 2:
Mailing Address - City:NEW SALEM
Mailing Address - State:PA
Mailing Address - Zip Code:15468-0709
Mailing Address - Country:US
Mailing Address - Phone:724-562-8239
Mailing Address - Fax:
Practice Address - Street 1:56 NORTH MILL STREET
Practice Address - Street 2:
Practice Address - City:NEW SALEM
Practice Address - State:PA
Practice Address - Zip Code:15468
Practice Address - Country:US
Practice Address - Phone:724-562-8239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
PAPC006581101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional