Provider Demographics
NPI:1447378690
Name:NEVELING, ELLIE (ELEANOR) A (RN, MED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:ELLIE (ELEANOR)
Middle Name:A
Last Name:NEVELING
Suffix:
Gender:F
Credentials:RN, MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1152 W ROSEMONT DR
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-2126
Mailing Address - Country:US
Mailing Address - Phone:484-554-6355
Mailing Address - Fax:610-974-8180
Practice Address - Street 1:1152 W ROSEMONT DR
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-2126
Practice Address - Country:US
Practice Address - Phone:484-554-6355
Practice Address - Fax:610-974-8180
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003741101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional