Provider Demographics
NPI:1164638433
Name:MATAY, NORMA MARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NORMA
Middle Name:MARIE
Last Name:MATAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:NORMA
Other - Middle Name:MARIE
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1405 3RD AVE
Mailing Address - Street 2:BLDG # 4
Mailing Address - City:SPRING LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07762
Mailing Address - Country:US
Mailing Address - Phone:732-370-8391
Mailing Address - Fax:732-370-8391
Practice Address - Street 1:1405 3RD AVE
Practice Address - Street 2:BLDG # 4
Practice Address - City:SPRING LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07762
Practice Address - Country:US
Practice Address - Phone:732-370-8391
Practice Address - Fax:732-370-8391
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC051742001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical