Provider Demographics
NPI:1417159856
Name:MATOS, ALLISON PAIGE (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:ALLISON
Middle Name:PAIGE
Last Name:MATOS
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 1:65 CORTLAND PL
Mailing Address - Street 2:
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-2820
Mailing Address - Country:US
Mailing Address - Phone:201-943-7944
Mailing Address - Fax:
Practice Address - Street 1:222 KINDERKAMACK RD
Practice Address - Street 2:SUITE 102
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-2259
Practice Address - Country:US
Practice Address - Phone:845-893-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2010-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052512001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical