Provider Demographics
NPI:1497147342
Name:LAZARO, BEATA (MA)
Entity Type:Individual
Prefix:
First Name:BEATA
Middle Name:
Last Name:LAZARO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3153 MILAN ST APT N-3153
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-5838
Mailing Address - Country:US
Mailing Address - Phone:917-912-7500
Mailing Address - Fax:
Practice Address - Street 1:2200 HAMILTON ST STE 308
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-6359
Practice Address - Country:US
Practice Address - Phone:610-320-2366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-02
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010975101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional