Organization
MATRIX CLINICAL SERVICES
Active
Organization
MATRIX CLINICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEVLIN REGENIA DUNCAN PMHNP-BC (OWNER)
(609) 702-5884
Entity
Organization
Contact information
Practice address
1632 ROUTE 38, STE. A, LUMBERTON, NJ 08048-2923
(609) 702-5884
(609) 702-5882
Mailing address
1632 ROUTE 38, STE. A, LUMBERTON, NJ 08048-2923
(609) 702-5884
(609) 702-5882
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
26NJ00141700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0153061
—
NJ
01
—
122248AOY
MEDICARE NPI
NJ
01
—
1326234097
INDIVIDUAL NPI
NJ
Enumeration date
02/03/2009
Last updated
02/03/2009
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