Provider Demographics
NPI:1518998012
Name:EMERY, MATTHEW LYNN (PSYD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:LYNN
Last Name:EMERY
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 1:32 WHISPER CREEK DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-7770
Mailing Address - Country:US
Mailing Address - Phone:570-522-0304
Mailing Address - Fax:570-522-0475
Practice Address - Street 1:32 WHISPER CREEK DR
Practice Address - Street 2:SUITE 7
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-7770
Practice Address - Country:US
Practice Address - Phone:570-522-0304
Practice Address - Fax:570-522-0475
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015898103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAEM1824598OtherHIGHMARK BLUE SHIELD
PA1015206250001Medicaid