Julie L Iwanicki, MA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MF000683 Issued in PA

Practice address

264 E Broad St
Bethlehem, PA 18018-6278

Phone

(610) 866-9311

Fax

(610) 882-2072

NPI assigned

Sep 19, 2012

Last updated

Sep 19, 2012By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15246/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Psychology Associates of Bethlehem, PC

  • Psychologist
  • Bethlehem, PA
  • NPI 1518942655
  NPD (past)

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348012800000",
    "number": "1982954723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 CHERRY LN",
            "address_2": "APT E3",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180159534",
            "telephone_number": "203-648-7152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 E BROAD ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180186278",
            "telephone_number": "610-866-9311",
            "fax_number": "610-882-2072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWANICKI",
        "first_name": "JULIE",
        "middle_name": "L",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-19",
        "last_updated": "2012-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "PA",
            "license": "MF000683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zahid Islam, M.D.
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• Itnlehighvalley
• Kaitlin Ivins
• Kyleigh Ivory, M.ED BSL
• Manny Subramania Iyer, M.D.
• J&M Medical Supply
• Gazal Jabir
• Jack Gold Surgical Appliances, Inc. (AlliedOP, Inc.)
• Marciette Jackson-Lazaroff, BEHAVIOR SPECIALIST

• Marriage & Family Therapist in Bethlehem, PA
• Providers in Bethlehem, PA by specialty
• Marriage & Family Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; 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.