Healthcare Provider Details

I. General information

NPI: 1568389658
Provider Name (Legal Business Name): NAILA MENDEZ
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 S 4TH ST
EMMAUS PA
18049-3802
US

IV. Provider business mailing address

3423 LIMESTONE DR
WHITEHALL PA
18052-7459
US

V. Phone/Fax

Practice location:
  • Phone: 610-762-8690
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPC002529
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: