Provider Demographics
NPI:1649558909
Name:MCPHAUL, PENNY (MAPC)
Entity Type:Individual
Prefix:
First Name:PENNY
Middle Name:
Last Name:MCPHAUL
Suffix:
Gender:F
Credentials:MAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-6611
Mailing Address - Country:US
Mailing Address - Phone:610-360-4342
Mailing Address - Fax:
Practice Address - Street 1:52 E BROAD ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-5948
Practice Address - Country:US
Practice Address - Phone:610-442-0939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral