Provider Demographics
NPI:1467451351
Name:MATERNA, JILL KLINGENSTEIN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:KLINGENSTEIN
Last Name:MATERNA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 N HERMITAGE RD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-3234
Mailing Address - Country:US
Mailing Address - Phone:724-346-4510
Mailing Address - Fax:724-346-4511
Practice Address - Street 1:701 N HERMITAGE RD
Practice Address - Street 2:SUITE 9
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-3234
Practice Address - Country:US
Practice Address - Phone:724-346-4510
Practice Address - Fax:724-346-4511
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2014-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007793L103TC0700X, 103T00000X, 103TA0400X, 103TA0700X, 103TB0200X, 103TM1800X, 103TF0000X, 103TH0100X, 103TH0004X
OH5549103T00000X
PAPS004493L103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth