Provider Demographics
NPI:1669690442
Name:MATSON, STEPHEN G (MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:G
Last Name:MATSON
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 ELM STREET
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-4196
Mailing Address - Country:US
Mailing Address - Phone:973-539-3839
Mailing Address - Fax:973-539-5224
Practice Address - Street 1:14 ELM ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-8101
Practice Address - Country:US
Practice Address - Phone:973-539-3839
Practice Address - Fax:973-539-5224
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC011674001041C0700X
NJ37FIOO104400106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist