Provider Demographics
NPI:1134670755
Name:MATRIX MENTAL HEALTH MANAGEMENT PC
Entity Type:Organization
Organization Name:MATRIX MENTAL HEALTH MANAGEMENT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:MEYER
Authorized Official - Middle Name:
Authorized Official - Last Name:SEEVE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-814-5885
Mailing Address - Street 1:1858 ATTAYA RD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-2901
Mailing Address - Country:US
Mailing Address - Phone:732-814-5885
Mailing Address - Fax:
Practice Address - Street 1:1858 ATTAYA RD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-2901
Practice Address - Country:US
Practice Address - Phone:732-814-5885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-19
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055998001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty