Provider Demographics
NPI:1437910288
Name:SEARLE, STACIE ANNE
Entity Type:Individual
Prefix:
First Name:STACIE
Middle Name:ANNE
Last Name:SEARLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1157 MARBLE DR
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-1640
Mailing Address - Country:US
Mailing Address - Phone:315-484-8671
Mailing Address - Fax:
Practice Address - Street 1:701 W BROAD ST STE 217
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-5229
Practice Address - Country:US
Practice Address - Phone:315-484-8671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW139962104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker