Provider Demographics
NPI:1073773339
Name:INDIVIDUAL AND FAMILY COUNSELING SERVICES OF THE LEHIGH VALLEY, P.C.
Entity Type:Organization
Organization Name:INDIVIDUAL AND FAMILY COUNSELING SERVICES OF THE LEHIGH VALLEY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRANDOLINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-799-5772
Mailing Address - Street 1:3155 WALNUT DR
Mailing Address - Street 2:
Mailing Address - City:SCHNECKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18078-2841
Mailing Address - Country:US
Mailing Address - Phone:610-799-5772
Mailing Address - Fax:
Practice Address - Street 1:5000 W TILGHMAN ST
Practice Address - Street 2:SUITE 206
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9109
Practice Address - Country:US
Practice Address - Phone:610-799-5772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006645L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty