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IRENE M DOUGHERTY LPC
NPI 1104000157
Counselor - Professional in Philadelphia, PA

Active since December 27, 2007PECOS Enrolled
407 FAIRMOUNT AVE, PHILADELPHIA, PA 19123(215) 796-2481(215) 627-6766 Get Directions Write a Review

NPPES record last updated: December 27, 2007. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Irene M Dougherty Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IRENE M DOUGHERTY LPC (NPI 1104000157) is an individual professional provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (PC003468) and active in the NPI registry since December 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2000).

NPPES Registry Identity

NPI1104000157
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameIRENE M DOUGHERTYCredential: LPC
Location Address407 FAIRMOUNT AVEPhiladelphia, PA 19123-2807
Mailing Address407 Fairmount AvePhiladelphia, PA 19123-2807 · (215) 796-2481 · Fax (215) 627-6766
Phone(215) 796-2481
Fax(215) 627-6766
Sole ProprietorYes
Medical School CMSOtherGraduated 2000
Enumeration DateDecember 27, 2007
✔ NPI 1104000157 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in PA · PC003468
407 FAIRMOUNT AVE, Philadelphia, PA 19123
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Irene M Dougherty Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7416429386
PECOS Enrollment IDI20260611004207
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Irene Dougherty's NPI number?

The NPI number for Irene Dougherty is 1104000157. It was assigned to this individual provider in the NPPES registry on December 27, 2007.

Where is Irene Dougherty located?

Irene Dougherty practices at 407 Fairmount Ave, Philadelphia, PA 19123. The listed phone number is (215) 796-2481.

What is Irene Dougherty's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Irene Dougherty enrolled in Medicare?

Yes. Irene Dougherty is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Irene Dougherty was last updated on December 27, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.