Healthcare Provider Details

I. General information

NPI: 1649187881
Provider Name (Legal Business Name): LYDIA PATSELAS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

486 NORRISTOWN RD STE 133
BLUE BELL PA
19422-2353
US

IV. Provider business mailing address

1100 ADAMS AVE STE 100
AUDUBON PA
19403-2404
US

V. Phone/Fax

Practice location:
  • Phone: 610-247-7724
  • Fax:
Mailing address:
  • Phone: 610-389-9090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC019943
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: