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 1:2151 EMRICK BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-8039
Mailing Address - Country:US
Mailing Address - Phone:484-537-7515
Mailing Address - Fax:
Practice Address - Street 1:2151 EMRICK BLVD STE 201
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-8039
Practice Address - Country:US
Practice Address - Phone:484-537-7515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAPC000600101YP2500X
PAPC018055101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional