Matt Shollenberger, PHD

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC002868 Issued in PA

Practice address

833 N Park Rd Ste 204
Wyomissing, PA 19610-1341

Phone

(484) 459-6423

Fax

(484) 388-4359

NPI assigned

Sep 2, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Matt Shollenberger, PHD PC

  • Professional Counselor
  • Wyomissing, PA
  • NPI 1063706315
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1063514875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 N PARK RD STE 204",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101341",
            "telephone_number": "484-459-6423",
            "fax_number": "484-388-4359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 N PARK RD STE 204",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101341",
            "telephone_number": "484-459-6423",
            "fax_number": "484-388-4359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOLLENBERGER",
        "first_name": "MATT",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC002868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "2319238000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7784522",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "592454000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Colette Simon, M.D.

• Professional Counselor in Wyomissing, PA
• Providers in Wyomissing, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.