Provider Demographics
NPI:1689481491
Name:ELLISON, ALYSON (LPC)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:
Last Name:ELLISON
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 1:3201 HIGHFIELD DR STE M
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-1113
Mailing Address - Country:US
Mailing Address - Phone:484-626-1241
Mailing Address - Fax:
Practice Address - Street 1:3201 HIGHFIELD DR STE M
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-1113
Practice Address - Country:US
Practice Address - Phone:484-626-1241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC018034101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional