Provider Demographics
NPI:1841900495
Name:O'HANLON, KELLY NICOLE (MS, LPC)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:NICOLE
Last Name:O'HANLON
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 E GOEPP ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-2817
Mailing Address - Country:US
Mailing Address - Phone:484-619-2104
Mailing Address - Fax:484-251-8554
Practice Address - Street 1:74 W BROAD ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-5738
Practice Address - Country:US
Practice Address - Phone:484-619-2104
Practice Address - Fax:484-251-8554
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC018055101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional