Provider Demographics
NPI:1609215235
Name:AMBROGI, MAY BASSEM (LCSW)
Entity Type:Individual
Prefix:
First Name:MAY
Middle Name:BASSEM
Last Name:AMBROGI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MAY
Other - Middle Name:BASSEM
Other - Last Name:LABBAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-3801
Mailing Address - Country:US
Mailing Address - Phone:610-390-6254
Mailing Address - Fax:
Practice Address - Street 1:35 E ELIZABETH AVE
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-6505
Practice Address - Country:US
Practice Address - Phone:610-390-6254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-17
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0177091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical