Provider Demographics
NPI:1255652269
Name:RAPOPORT, WENDY MYRA (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:MYRA
Last Name:RAPOPORT
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 ALLEN STREET
Mailing Address - Street 2:JFS
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-5007
Mailing Address - Country:US
Mailing Address - Phone:610-821-8722
Mailing Address - Fax:610-821-8925
Practice Address - Street 1:2004 ALLEN STREET
Practice Address - Street 2:JEWISH FAMILY SERVICE OF THE LEHIGH VALLEY
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-5007
Practice Address - Country:US
Practice Address - Phone:610-821-8722
Practice Address - Fax:610-821-8925
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-14
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW016356101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health