Provider Demographics
NPI:1861519928
Name:THE ACADEMY-APT CLINICAL CONSULTANTS, INC
Entity type:Organization
Organization Name:THE ACADEMY-APT CLINICAL CONSULTANTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ADELE
Authorized Official - Middle Name:C
Authorized Official - Last Name:BON-SHANNON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW,LCSW
Authorized Official - Phone:610-866-2744
Mailing Address - Street 1:701 W BROAD ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-5248
Mailing Address - Country:US
Mailing Address - Phone:610-866-2744
Mailing Address - Fax:610-282-3795
Practice Address - Street 1:701 W BROAD ST
Practice Address - Street 2:SUITE 201
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-5248
Practice Address - Country:US
Practice Address - Phone:610-866-2744
Practice Address - Fax:610-282-3795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0128521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PABO 644037Medicare ID - Type Unspecified