Healthcare Provider Details

I. General information

NPI: 1689515389
Provider Name (Legal Business Name): MATTHEW BROOKS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 FARVIEW TER
PARAMUS NJ
07652-2761
US

IV. Provider business mailing address

15 FARVIEW TER
PARAMUS NJ
07652-2761
US

V. Phone/Fax

Practice location:
  • Phone: 551-579-4441
  • Fax:
Mailing address:
  • Phone: 551-579-4441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SL07405900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: