Healthcare Provider Details

I. General information

NPI: 1063346088
Provider Name (Legal Business Name): LAUREN STACK MS, LAPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 E ELIZABETH AVE STE 400
BETHLEHEM PA
18018-6515
US

IV. Provider business mailing address

1883 MOUNT BETHEL HWY
MOUNT BETHEL PA
18343-5203
US

V. Phone/Fax

Practice location:
  • Phone: 570-431-3259
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPC002449
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: