Healthcare Provider Details

I. General information

NPI: 1366752537
Provider Name (Legal Business Name): LENORE EDITH STINE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2010
Last Update Date: 04/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 E ELIZABETH AVE
BETHLEHEM PA
18018-6504
US

IV. Provider business mailing address

51 E ELIZABETH AVE
BETHLEHEM PA
18018-6504
US

V. Phone/Fax

Practice location:
  • Phone: 610-360-7526
  • Fax: 888-206-1668
Mailing address:
  • Phone: 610-360-7526
  • Fax: 888-206-1668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberPC005632
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC005632
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: