Provider Demographics
NPI:1669232799
Name:SHAY, KATHERINE ELLEN (LPC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ELLEN
Last Name:SHAY
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 1:62 CORRIERE RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-7428
Mailing Address - Country:US
Mailing Address - Phone:908-619-4268
Mailing Address - Fax:
Practice Address - Street 1:62 CORRIERE RD
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-7428
Practice Address - Country:US
Practice Address - Phone:908-619-4268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC014106101YP2500X
NJ37PC00828600101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional