Healthcare Provider Details

I. General information

NPI: 1568820736
Provider Name (Legal Business Name): PAMELA KAY SMITH LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2016
Last Update Date: 06/11/2020
Certification Date: 06/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 NORTHAMPTON ST SUITE 201
EASTON PA
18042-4152
US

IV. Provider business mailing address

1114 WEBSTER AVE
ALLENTOWN PA
18103-5345
US

V. Phone/Fax

Practice location:
  • Phone: 610-559-8151
  • Fax:
Mailing address:
  • Phone: 610-739-9650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC010762
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: