Healthcare Provider Details

I. General information

NPI: 1255030060
Provider Name (Legal Business Name): ALICE ERINN SPINA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2023
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

257 BRODHEAD RD
BETHLEHEM PA
18017-8938
US

IV. Provider business mailing address

801 OSTRUM ST
BETHLEHEM PA
18015-1000
US

V. Phone/Fax

Practice location:
  • Phone: 484-822-5700
  • Fax: 484-822-5796
Mailing address:
  • Phone: 484-526-4999
  • Fax: 833-213-6428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW023100
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: