Provider Demographics
NPI:1215788740
Name:FITZGERALD, MATTHEW JAMES ZAHKA (MS, LPC, NCC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:JAMES ZAHKA
Last Name:FITZGERALD
Suffix:
Gender:M
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 WOODLAND AVE # COTTAGEB
Mailing Address - Street 2:
Mailing Address - City:AVON BY THE SEA
Mailing Address - State:NJ
Mailing Address - Zip Code:07717-2102
Mailing Address - Country:US
Mailing Address - Phone:732-759-0707
Mailing Address - Fax:
Practice Address - Street 1:419 WOODLAND AVE # COTTAGEB
Practice Address - Street 2:
Practice Address - City:AVON BY THE SEA
Practice Address - State:NJ
Practice Address - Zip Code:07717-2102
Practice Address - Country:US
Practice Address - Phone:732-759-0707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling