Healthcare Provider Details
I. General information
NPI: 1831073188
Provider Name (Legal Business Name): FRUITFUL SEEDS COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/31/2025
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
541 E BROAD ST
BETHLEHEM PA
18018-6314
US
IV. Provider business mailing address
1576 FLEMING ST
BETHLEHEM PA
18017-6207
US
V. Phone/Fax
- Phone: 484-221-2411
- Fax:
- Phone: 484-221-2411
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MISS
JENNIFER
BRUNO
Title or Position: THERAPIST/OWNER
Credential: LCSW
Phone: 484-221-2411