Provider Demographics
NPI:1942727706
Name:MENARD, MATTHEW (LPC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:MENARD
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 WILLOUGHBY AVE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:PA
Mailing Address - Zip Code:16365-1474
Mailing Address - Country:US
Mailing Address - Phone:412-848-8955
Mailing Address - Fax:
Practice Address - Street 1:436 PA AVE W
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:PA
Practice Address - Zip Code:16365-2238
Practice Address - Country:US
Practice Address - Phone:412-848-8955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-23
Last Update Date:2023-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008925101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional