MEDICARE: MATTHEW NAGEL MA, LPC

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	101YP2500X	Professional Counselor	PC007542	PA

General Provider Information

NPI Number	:	1952711921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW NAGEL MA, LPC

Provider Business Mailing Address
First Line	:	16265 CONNEAUT LAKE RD
Second Line	:	SUITE 1391
City	:	MEADVILLE
State	:	PA
Zip	:	16335-3861
Country	:	US
Telephone Number	:	814-807-1330
Fax Number	:	814-807-1338

Provider Business Practice Location Address
First Line	:	16265 CONNEAUT LAKE RD
Second Line	:	SUITES 1391 AND 1389
City	:	MEADVILLE
State	:	PA
Zip	:	16335-3861
Country	:	US
Telephone Number	:	814-336-1011
Fax Number	:

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

Provider Enumeration Date	:	04/30/2014
Last Update Date	:	09/23/2015

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