Provider Demographics
NPI:1568444602
Name:MATERNA, DANIEL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:MATERNA
Suffix:
Gender:M
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:BUILDING 1, LOWER LEVEL
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:BUILDING 1, LOWER LEVEL
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:2005-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006635L103TC0700X, 103T00000X, 103TA0400X, 103TA0700X, 103TB0200X, 103TC2200X, 103TF0000X, 103TH0100X, 103TM1800X, 103TH0004X
OH5444103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
Not Answered103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Not Answered103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Not Answered103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
Not Answered103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth