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Organization
PA MENTAL HEALTH
Active
Organization
PA MENTAL HEALTH
Active
Other names
PA Mental Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIGUEL A MATOS LPC (LICENSED MENTAL HEALTH COUN CEO)
(908) 759-2376
Entity
Organization
Contact information
Practice address
204 ERIE ST STE 2FL, ELIZABETH, NJ 07206-1569
(908) 759-2370
(908) 469-5817
Mailing address
204 ERIE ST STE 2FL, ELIZABETH, NJ 07206-1569
(908) 759-2370
(908) 469-5817
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033399555
NPI
PA
Enumeration date
12/28/2018
Last updated
12/28/2018
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