Active NPI
Elyse C Lubell, PHD
- Clinical Child & Adolescent Psychologist
- Allentown, PA
National Provider Identifier
1144254400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- PS015440
- Practice address
- 6201 Hamilton Blvd
Suite 202
Allentown, PA 18104 - Phone
- (484) 553-1252
- Fax
- (610) 398-1949
- NPI assigned
- Jul 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | PS015440 | PA | Primary |
Addresses
Primary practice location
6201 Hamilton Blvd
Suite 202
Allentown, PA 18104
Mailing address
197 Windermere Ave
Allentown, PA 18104
Phone (484) 553-1252
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2312064000 | Other | PA | BLUE SHIELD PERSONAL CHOI |
| 1637239 | Other | PA | BLUE SHIELD HIGHMARK |
| G3543673 | Other | PA | OXFORD HEALTH |
| 50058544 | Other | PA | BLUE SHIELD CAPITAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144254400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "197 WINDERMERE AVE",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "18104",
"telephone_number": "484-553-1252",
"fax_number": "610-398-1949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6201 HAMILTON BLVD",
"address_2": "SUITE 202",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "18104",
"telephone_number": "484-553-1252",
"fax_number": "610-398-1949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUBELL",
"first_name": "ELYSE",
"middle_name": "C",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "PA",
"license": "PS015440",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD PERSONAL CHOI",
"identifier": "2312064000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD HIGHMARK",
"identifier": "1637239",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH",
"identifier": "G3543673",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD CAPITAL",
"identifier": "50058544",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Allentown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.