Healthcare Provider Details

I. General information

NPI: 1811810963
Provider Name (Legal Business Name): MARC HARLEY HABEL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

844 W MARKET ST
KINGSTON PA
18704-3302
US

IV. Provider business mailing address

1039 CLAY AVE FL 1
SCRANTON PA
18510-1133
US

V. Phone/Fax

Practice location:
  • Phone: 570-309-8778
  • Fax:
Mailing address:
  • Phone: 570-309-8778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBH008675
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: