Provider Demographics
NPI:1144817859
Name:GEBHARDT, ALEXANDER JOHN (BS)
Entity type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:JOHN
Last Name:GEBHARDT
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 ROBERT MORRIS BLVD APT 205
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-4572
Mailing Address - Country:US
Mailing Address - Phone:484-538-3995
Mailing Address - Fax:
Practice Address - Street 1:2760 EMRICK BLVD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-8012
Practice Address - Country:US
Practice Address - Phone:484-538-3995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA106S00000X
PABH007794103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician