Provider Demographics
NPI:1356989024
Name:DIMATTEO, MARIE (LPC)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:DIMATTEO
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3498
Mailing Address - Country:US
Mailing Address - Phone:732-803-1670
Mailing Address - Fax:
Practice Address - Street 1:27 MAIN ST
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-3498
Practice Address - Country:US
Practice Address - Phone:732-803-1670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-12
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC01102800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health