Provider Demographics
NPI:1104657428
Name:SPELLACY, ELIZABETH M (LAPC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:SPELLACY
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 MEADOWBROOK CIR W
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-5469
Mailing Address - Country:US
Mailing Address - Phone:347-937-4854
Mailing Address - Fax:
Practice Address - Street 1:51 E ELIZABETH AVE
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-6504
Practice Address - Country:US
Practice Address - Phone:610-360-7526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAPC000281101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health