MEDICARE: DR. PETER J. BEHRENS PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist	PS002353L	PA

General Provider Information

NPI Number	:	1003817834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER J. BEHRENS PH.D.

Provider Business Mailing Address
First Line	:	1819 MILLARD ST
Second Line	:
City	:	BETHLEHEM
State	:	PA
Zip	:	18017-5115
Country	:	US
Telephone Number	:	610-868-2372
Fax Number	:

Provider Business Practice Location Address
First Line	:	35 E ELIZABETH AVE
Second Line	:	SUITE 30
City	:	BETHLEHEM
State	:	PA
Zip	:	18018-6505
Country	:	US
Telephone Number	:	610-865-7777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	03/14/2016

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