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General NPI Number Information
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NPI Number | 1932908506
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Entity Type | Individual
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Provider Name | ADAM MATTER LAC, NCC
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Gender | Male
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 28 MILLBURN AVE STE 8
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City | SPRINGFIELD
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State | NJ
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Zip | 07081-1023
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Country | US
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Telephone | 732-674-9857
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Fax |
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Provider Business Mailing Address
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Address Line | 97 VIVANTE BLVD # 303
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City | PUNTA GORDA
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State | FL
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Zip | 33950-2025
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Country | US
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Telephone | 732-674-9857
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 37AC00856500
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License Number State | NJ
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