Healthcare Provider Details

I. General information

NPI: 1750123824
Provider Name (Legal Business Name): MATRIX CLINICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2024
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 STILES RD STE 110
SALEM NH
03079-2877
US

IV. Provider business mailing address

8 STILES RD STE 110
SALEM NH
03079-2877
US

V. Phone/Fax

Practice location:
  • Phone: 781-367-6644
  • Fax:
Mailing address:
  • Phone: 781-367-6644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER CUTLER
Title or Position: OWNER
Credential: LCMHC
Phone: 781-367-6644