MEDICARE: MATTHEW DEBIASE M.S., N.C.C.,L.P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor		PA

General Provider Information

NPI Number	:	1649668518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW DEBIASE M.S., N.C.C.,L.P.C.

Provider Business Mailing Address
First Line	:	1846 MEMORIAL HWY
Second Line	:
City	:	SHAVERTOWN
State	:	PA
Zip	:	18708-1489
Country	:	US
Telephone Number	:	570-817-8532
Fax Number	:

Provider Business Practice Location Address
First Line	:	1172 TWIN STACKS DR
Second Line	:
City	:	DALLAS
State	:	PA
Zip	:	18612-8505
Country	:	US
Telephone Number	:	570-674-1505
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/31/2014
Last Update Date	:	06/19/2019

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