Provider Demographics
NPI:1992304455
Name:MATAS, SARAH B (LCSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:B
Last Name:MATAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:434 KENNETT PIKE
Mailing Address - Street 2:
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-9383
Mailing Address - Country:US
Mailing Address - Phone:610-357-3310
Mailing Address - Fax:
Practice Address - Street 1:434 KENNETT PIKE
Practice Address - Street 2:
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-9383
Practice Address - Country:US
Practice Address - Phone:610-357-3310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-25
Last Update Date:2020-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PANH007160376G00000X
PACW0165661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No376G00000XNursing Service Related ProvidersNursing Home Administrator