| Deadra Clewell Counseling, Llc | |
|
60 W Broad St Ste 99b Bethlehem PA 18018-5745 | |
| (610) 814-4869 | |
| (610) 814-4869 |
| Full Name | Deadra Clewell Counseling, Llc |
|---|---|
| Speciality | Counselor |
| Location | 60 W Broad St, Bethlehem, Pennsylvania |
| Authorized Official Name and Position | Deadra Clewell (OWNER/OPERATOR) |
| Authorized Official Contact | 6107371236 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Deadra Clewell Counseling, Llc 60 W Broad St Ste 99b Bethlehem PA 18018-5745 Ph: (610) 814-4869 | Deadra Clewell Counseling, Llc 60 W Broad St Ste 99b Bethlehem PA 18018-5745 Ph: (610) 814-4869 |
| NPI Number | 1700538311 |
|---|---|
| Provider Enumeration Date | 01/25/2022 |
| Last Update Date | 01/25/2022 |
| Certification Date | 01/25/2022 |
| Medicare PECOS PAC ID | 9335671304 |
|---|---|
| Medicare Enrollment ID | O20241015002996 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700538311 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Pratibha Kamble |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437455854 PECOS PAC ID: 0345696563 Enrollment ID: I20231025000164 |
| Provider Name | Deadra Clewell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437569803 PECOS PAC ID: 1254862980 Enrollment ID: I20241015004248 |
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