Rena Blaine Manela-Potzman, M.ED, LPC, PMH-C

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC014046 Issued in PA

Practice address

5508 Grace Ave
Bethlehem, PA 18017-9059

Phone

(610) 349-1139

NPI assigned

Dec 8, 2021

Last updated

Dec 8, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1801555727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5508 GRACE AVE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180179059",
            "telephone_number": "610-349-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5508 GRACE AVE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180179059",
            "telephone_number": "610-349-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANELA-POTZMAN",
        "first_name": "RENA",
        "middle_name": "BLAINE",
        "credential": "M.ED, LPC, PMH-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC014046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC014046",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "laptop",
            "affiliation": "N",
            "endpointDescription": "computer",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "direct",
            "address_1": "5508 Grace Ave",
            "city": "Bethlehem",
            "state": "PA",
            "country_code": "US",
            "postal_code": "180179059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Simone Malonga
• Nitya Bandla Mambalam, M.D,
• Amaravani Mandalapu, M.D.
• Sai A Mandalapu, MD
• Eiran Moses Mandelker, MD
• Hardik Mangrolia, MD
• Anne Elizabeth Mani, MD
• Syamala Mankala
• James Warren Manley, DO
• John A Mannisi, MD

• Professional Counselor in Bethlehem, PA
• Providers in Bethlehem, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.