Provider Demographics
NPI:1093149239
Name:MATEREK, KRISTEN R (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:R
Last Name:MATEREK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1088 HIGHWAY 34
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-1948
Mailing Address - Country:US
Mailing Address - Phone:732-290-1700
Mailing Address - Fax:732-290-0040
Practice Address - Street 1:1088 HIGHWAY 34
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:NJ
Practice Address - Zip Code:07747-1948
Practice Address - Country:US
Practice Address - Phone:732-290-1700
Practice Address - Fax:732-290-0040
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05720200101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor