Provider Demographics
NPI:1578954558
Name:MATOS, LUZ (LCSW)
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:
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 1:1 N WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-1875
Mailing Address - Country:US
Mailing Address - Phone:609-567-0434
Mailing Address - Fax:609-567-1169
Practice Address - Street 1:3003 ENGLISH CREEK AVE STE C6
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-4818
Practice Address - Country:US
Practice Address - Phone:609-481-3185
Practice Address - Fax:609-569-0104
Is Sole Proprietor?:No
Enumeration Date:2015-02-11
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC056648001041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical