Provider Demographics
NPI:1639998875
Name:VAN MATRE, ERIC JAMES JR (LPC-A)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:JAMES
Last Name:VAN MATRE
Suffix:JR
Gender:M
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 RANCHO CIR
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-5552
Mailing Address - Country:US
Mailing Address - Phone:832-433-8896
Mailing Address - Fax:
Practice Address - Street 1:731 RUTLAND ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-1527
Practice Address - Country:US
Practice Address - Phone:832-433-8896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96770101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional