Healthcare Provider Details

I. General information

NPI: 1205092657
Provider Name (Legal Business Name): MARSHA G VOSBURGH AUSTIN MA, CACD, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARSHA G VOSBURGH MA, CACD, LPC

II. Dates (important events)

Enumeration Date: 08/05/2008
Last Update Date: 09/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 WESTGATE DRIVE STE 301
BETHLEHEM PA
18017
US

IV. Provider business mailing address

2045 WESTGATE DRIVE STE 301
BETHLEHEM PA
18017
US

V. Phone/Fax

Practice location:
  • Phone: 610-419-3101
  • Fax: 610-419-3309
Mailing address:
  • Phone: 610-419-3101
  • Fax: 610-419-3309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPC004551
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberPC004551
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC004551
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberPC004551
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC004551
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: