Provider Demographics
NPI:1922192475
Name:MATERNA PSYCHOLOGICAL SERVICES, PC
Entity Type:Organization
Organization Name:MATERNA PSYCHOLOGICAL SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MATERNA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:724-346-4510
Mailing Address - Street 1:701 N. HERMITAGE RD.
Mailing Address - Street 2:BUILDING ONE, LOWER LEVEL
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-3250
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 ONE, LOWER LEVEL
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-3250
Practice Address - Country:US
Practice Address - Phone:724-346-4510
Practice Address - Fax:724-346-4511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006635L103T00000X, 103TA0400X, 103TA0700X, 103TB0200X, 103TC0700X, 103TC2200X, 103TF0000X, 103TH0004X
PAPS007793L103T00000X, 103TA0700X, 103TB0200X, 103TC0700X, 103TC2200X, 103TF0000X, 103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Multi-Specialty
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Multi-Specialty
Not Answered103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Multi-Specialty