NPIMap

Organization Active NPI

Deadra Clewell Counseling, LLC

  • Professional Counselor
  • Bethlehem, PA
National Provider Identifier
1700538311
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
DEADRA CLEWELL COUNSELING, LLC
Practice address
60 W Broad St
Ste 99B
Bethlehem, PA 18018-5745
Phone
(610) 814-4869
Fax
(610) 814-4869
NPI assigned
Jan 25, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Deadra Clewell, PHDNPI 1437569803
Title
Owner/Operator
Phone
(610) 737-1236

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

60 W Broad St
Ste 99B
Bethlehem, PA 18018-5745

Mailing address

60 W Broad St
Ste 99B
Bethlehem, PA 18018-5745
Phone (610) 814-4869

Other names 1

  • Deadra Clewell Counseling Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Bethlehem Other Deadra Clewell Counseling

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241015002996 PA Part B Supplier - Clinic/Group Practice 9335671304 Receives reassigned benefits from 2 practitioners
Practice locations: Bethlehem, PA

National Provider Directory

National Provider Directory

Locations

60 W Broad St
Ste 99B
Bethlehem, PA 18018
Phone (610) 814-4869

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1700538311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 W BROAD ST",
            "address_2": "STE 99B",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180185745",
            "telephone_number": "610-814-4869",
            "fax_number": "610-814-4869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 W BROAD ST",
            "address_2": "STE 99B",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180185745",
            "telephone_number": "610-814-4869",
            "fax_number": "610-814-4869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEADRA CLEWELL COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "CLEWELL",
        "authorized_official_first_name": "DEADRA",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "610-737-1236",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Bethlehem",
            "affiliation": "Y",
            "endpointDescription": "other",
            "affiliationName": "Deadra Clewell Counseling",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Bethlehem",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "independent practice",
            "address_1": "60 W Broad St",
            "address_2": "Ste 99B",
            "city": "Bethlehem",
            "state": "PA",
            "country_code": "US",
            "postal_code": "180185745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Deadra Clewell Counseling",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Bethlehem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.