Healthcare Provider Details

I. General information

NPI: 1659298008
Provider Name (Legal Business Name): MARLYNE BEAUVAIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 E ELIZABETH AVE STE 112
BETHLEHEM PA
18018-6502
US

IV. Provider business mailing address

717 TROUT CREEK LN
ALLENTOWN PA
18103-4974
US

V. Phone/Fax

Practice location:
  • Phone: 570-239-6888
  • Fax:
Mailing address:
  • Phone: 570-239-6888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: