Healthcare Provider Details

I. General information

NPI: 1558764688
Provider Name (Legal Business Name): ELIZABETH ROHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2014
Last Update Date: 05/22/2020
Certification Date: 05/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 SCHOENERSVILLE RD
BETHLEHEM PA
18017-3574
US

IV. Provider business mailing address

1605 N CEDAR CREST BLVD STE 411
ALLENTOWN PA
18104-2323
US

V. Phone/Fax

Practice location:
  • Phone: 610-297-7500
  • Fax: 610-297-7533
Mailing address:
  • Phone: 610-969-1914
  • Fax: 610-969-3951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL05645500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW126839
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW018715
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: