Provider Demographics
NPI:1962259663
Name:MATTHEWS, ELIZABETH R (MS, LPC, NCC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:R
Last Name:MATTHEWS
Suffix:
Gender:F
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 1:132 MOCKINGBIRD CT
Mailing Address - Street 2:
Mailing Address - City:THREE BRIDGES
Mailing Address - State:NJ
Mailing Address - Zip Code:08887-2112
Mailing Address - Country:US
Mailing Address - Phone:732-570-7087
Mailing Address - Fax:
Practice Address - Street 1:340 NORTH AVE E STE 1A
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2461
Practice Address - Country:US
Practice Address - Phone:908-913-7704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-01
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00956700101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty