Provider Demographics
NPI:1659030567
Name:MERANDA, MARCELLA DALE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARCELLA
Middle Name:DALE
Last Name:MERANDA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:MARCELLA
Other - Middle Name:DALE
Other - Last Name:FRIEND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1908 FERNWAY AVE
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-2115
Mailing Address - Country:US
Mailing Address - Phone:484-548-3525
Mailing Address - Fax:
Practice Address - Street 1:1908 FERNWAY AVE
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-2115
Practice Address - Country:US
Practice Address - Phone:484-548-3525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0159561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical