Healthcare Provider Details

I. General information

NPI: 1689585564
Provider Name (Legal Business Name): EVI A SKOUTELAS LAPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2030 W TILGHMAN ST
ALLENTOWN PA
18104-4354
US

IV. Provider business mailing address

1 E BROAD ST STE 130
BETHLEHEM PA
18018-5934
US

V. Phone/Fax

Practice location:
  • Phone: 610-437-2370
  • Fax:
Mailing address:
  • Phone: 484-504-9625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPC002689
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: