Provider Demographics
NPI:1235615816
Name:MATIJAS-ROTH, MAUREEN E (LPC)
Entity type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:E
Last Name:MATIJAS-ROTH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:MAUREEN
Other - Middle Name:E
Other - Last Name:ROTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:401 EDEN ROAD
Mailing Address - Street 2:APARTMENT F3
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601
Mailing Address - Country:US
Mailing Address - Phone:717-608-0400
Mailing Address - Fax:717-774-6680
Practice Address - Street 1:1929 LINCOLN HIGHWAY EAST
Practice Address - Street 2:SUITE 150
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602
Practice Address - Country:US
Practice Address - Phone:717-947-6535
Practice Address - Fax:717-390-1970
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010545101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional