Organization
AUTISM SPECIFIC CONSULTING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH JOHN MATSKO JR. BSL (PRESIDENT)
(570) 354-2127
Entity
Organization
Contact information
Practice address
201 LACKAWANNA AVE STE 314, SCRANTON, PA 18503-1953
(570) 354-2127
(570) 507-9657
Mailing address
201 LACKAWANNA AVE STE 314, SCRANTON, PA 18503-1953
(570) 540-9428
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH001844
PA
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1034027290003
—
PA
Enumeration date
12/12/2017
Last updated
12/15/2019
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