Provider Demographics
NPI:1205092657
Name:VOSBURGH AUSTIN, MARSHA G (MA, CACD, LPC)
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:G
Last Name:VOSBURGH AUSTIN
Suffix:
Gender:F
Credentials:MA, CACD, LPC
Other - Prefix:
Other - First Name:MARSHA
Other - Middle Name:G
Other - Last Name:VOSBURGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CACD, LPC
Mailing Address - Street 1:2045 WESTGATE DRIVE
Mailing Address - Street 2:STE 301
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017
Mailing Address - Country:US
Mailing Address - Phone:610-419-3101
Mailing Address - Fax:610-419-3309
Practice Address - Street 1:2045 WESTGATE DRIVE
Practice Address - Street 2:STE 301
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017
Practice Address - Country:US
Practice Address - Phone:610-419-3101
Practice Address - Fax:610-419-3309
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004551101Y00000X, 101YA0400X, 101YM0800X, 101YP1600X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC004551OtherPROFESSIONAL LICENSE