Basic Information
| Provider Information | |||||||||
| NPI: | 1619445889 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DEMATTEO | ||||||||
| FirstName: | VALERIE | ||||||||
| MiddleName: | |||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 SHENANGO AVE | ||||||||
| Address2: | |||||||||
| City: | SHARON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 161461503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7243423002 | ||||||||
| FaxNumber: | 7243421942 | ||||||||
| Practice Location | |||||||||
| Address1: | 529 LLOYD AVE | ||||||||
| Address2: | |||||||||
| City: | LATROBE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 156501721 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7248045195 | ||||||||
| FaxNumber: | 7248045980 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2018 | ||||||||
| LastUpdateDate: | 05/06/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | PC008910 | PA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
ID Information
| ID | Type | State | Issuer | Description | PC008910 | 01 | PA | PROFESSIONAL COUNSELOR | OTHER |