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General NPI Number Information
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NPI Number | 1063706315
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Entity Type | Organization
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Legal Business Name | MATT SHOLLENBERGER, PHD PC
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Dates
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Enumeration Date | 06/03/2011
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Last Update Date | 07/27/2020
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Provider Practice Location Address
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Address Line | 833 NORTH PARK ROAD SUITE 204
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City | WYOMISSING
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State | PA
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Zip | 19610
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Country | US
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Telephone | 484-459-6423
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Fax | 484-388-4359
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Provider Business Mailing Address
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Address Line | 833 N PARK RD STE 204
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City | WYOMISSING
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State | PA
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Zip | 19610-1341
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Country | US
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Telephone | 484-459-6423
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Fax | 484-388-4359
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Authorized Official
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Title or Position | OWNER/COUNSELOR
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Name | DR. MATT SHOLLENBERGER
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Credential | PH.D.
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Telephone | 484-459-6423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC002868
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License Number State | PA
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