Healthcare Provider Details
I. General information
NPI: 1003320672
Provider Name (Legal Business Name): SENIOR CARE THERAPY OF PENNSYLVANIA, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/19/2017
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
815 CHESTER PIKE
PROSPECT PARK PA
19076-2322
US
IV. Provider business mailing address
575 STATE ROUTE 28 BUILDING TWO, STE 2108
RARITAN NJ
08869
US
V. Phone/Fax
- Phone: 973-264-0023
- Fax: 973-264-0022
- Phone: 973-264-0023
- Fax: 973-264-0022
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MATTHEW
BARNAS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MD
Phone: 973-264-0023