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Organization

MATCLINIC PHYSICIANS PRACTICE GROUP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAN RECK (MANAGER)
(410) 220-0720
Entity
Organization

Contact information

Practice address
531 OLD WESTMINSTER PIKE STE 102, WESTMINSTER, MD 21157-6277
(410) 220-0720
(410) 862-0150
Mailing address
PO BOX 9068, BALTIMORE, MD 21222-0768
(410) 220-0720
(410) 862-0150

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
2084P0800X
Psychiatry Physician
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Enumeration date
06/30/2021
Last updated
12/10/2025
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