Provider Demographics
NPI:1922019835
Name:BHALLO, SAJEDA M (MS, CAC)
Entity Type:Individual
Prefix:
First Name:SAJEDA
Middle Name:M
Last Name:BHALLO
Suffix:
Gender:F
Credentials:MS, CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1728 W JONATHAN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-3170
Mailing Address - Country:US
Mailing Address - Phone:610-938-1898
Mailing Address - Fax:
Practice Address - Street 1:807 LAWN AVE
Practice Address - Street 2:
Practice Address - City:SELLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18960-1549
Practice Address - Country:US
Practice Address - Phone:215-257-6551
Practice Address - Fax:215-453-5181
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA4507101YA0400X
PAPC011376101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)