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Organization

ELYSE C LUBELL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ELYSE C LUBELL PHD (PRESIDENT)
(484) 553-1252
Entity
Organization

Contact information

Practice address
6201 HAMILTON BLVD, ALLENTOWN, PA 18106-9684
(484) 553-1252
(610) 398-1949
Mailing address
197 WINDERMERE AVE, ALLENTOWN, PA 18104-8665
(484) 553-1252
(610) 398-1949

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PS015440
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1918086
HIGHMARK BLUE SHIELD
PA
01
50049223
CAPITAL BLUE CROSS
PA
01
G3543672
OXFORD HEALTH
PA
Enumeration date
05/11/2007
Last updated
08/22/2020
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