Healthcare Provider Details

I. General information

NPI: 1578776399
Provider Name (Legal Business Name): SUZANNE ELAYNE MESSNER MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 S 21ST ST
EASTON PA
18042-3835
US

IV. Provider business mailing address

175 S 21ST ST
EASTON PA
18042-3835
US

V. Phone/Fax

Practice location:
  • Phone: 610-559-8151
  • Fax: 610-559-9056
Mailing address:
  • Phone: 610-559-8151
  • Fax: 610-559-9056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC003874
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: