Provider Demographics
NPI:1851648372
Name:TRIVEDI, PRACHETA N (LPC)
Entity Type:Individual
Prefix:
First Name:PRACHETA
Middle Name:N
Last Name:TRIVEDI
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 1:2030 LEHIGH ST
Mailing Address - Street 2:107
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-3853
Mailing Address - Country:US
Mailing Address - Phone:610-467-7186
Mailing Address - Fax:
Practice Address - Street 1:2030 LEHIGH ST
Practice Address - Street 2:107
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3853
Practice Address - Country:US
Practice Address - Phone:610-467-7186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
PAPC007338101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)