Individual provider Active NPI

Selina Matis, LCSW

  • Clinical Social Worker
  • Lemont Furnace, PA
National Provider Identifier
1144459926
Registry record updated Jul 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW018596 Issued in PA
Practice address
2001 University Dr
Lemont Furnace, PA 15456-1029
Phone
(724) 320-2632
NPI assigned
Jul 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW018596 PA Primary

Addresses

Primary practice location

2001 University Dr
Lemont Furnace, PA 15456-1029

Mailing address

PO Box 495
Republic, PA 15475-0495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500336000000",
    "number": "1144459926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 495",
            "city": "REPUBLIC",
            "state": "PA",
            "postal_code": "154750495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 UNIVERSITY DR",
            "city": "LEMONT FURNACE",
            "state": "PA",
            "postal_code": "154561029",
            "telephone_number": "724-320-2632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATIS",
        "first_name": "SELINA",
        "name_prefix": "Dr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-14",
        "last_updated": "2017-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW018596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lemont Furnace, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2017; 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.