Provider Demographics
NPI:1063691756
Name:MATLEE, AMANDA L (MSW LSW)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:L
Last Name:MATLEE
Suffix:
Gender:F
Credentials:MSW LSW
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:L
Other - Last Name:MATOVSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:330 PURSEL STREET
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-3435
Mailing Address - Country:US
Mailing Address - Phone:908-619-1601
Mailing Address - Fax:
Practice Address - Street 1:492 ROUTE 57 WEST
Practice Address - Street 2:FAMILY GUIDANCE CENTER OF WARREN COUNTY
Practice Address - City:WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07882-1420
Practice Address - Country:US
Practice Address - Phone:908-689-1000
Practice Address - Fax:908-689-4529
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05445600104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker