Healthcare Provider Details

I. General information

NPI: 1255319794
Provider Name (Legal Business Name): MICHAEL J. DOLAN PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2341 WALBERT AVE
ALLENTOWN PA
18104-1351
US

IV. Provider business mailing address

3155 SHAKESPEARE RD
BETHLEHEM PA
18017-2731
US

V. Phone/Fax

Practice location:
  • Phone: 610-434-2431
  • Fax: 610-434-8384
Mailing address:
  • Phone: 610-866-3492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License NumberPS-006761-L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS-006761-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: