Provider Demographics
NPI:1710116355
Name:DOERR, MARTHA S (LPC)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:S
Last Name:DOERR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 S CEDAR CREST BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-7903
Mailing Address - Country:US
Mailing Address - Phone:610-730-1982
Mailing Address - Fax:610-351-3672
Practice Address - Street 1:1125 S CEDAR CREST BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-7903
Practice Address - Country:US
Practice Address - Phone:610-730-1982
Practice Address - Fax:610-351-3672
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-03
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004527101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADO2108193OtherHIGHMARK BLUE SHIELD