Provider Demographics
NPI:1356942999
Name:MATTEO, DANIELLE (LPC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:MATTEO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 BEDFORD TER
Mailing Address - Street 2:
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-2102
Mailing Address - Country:US
Mailing Address - Phone:267-939-4888
Mailing Address - Fax:
Practice Address - Street 1:72 E HOLLY AVE STE 124
Practice Address - Street 2:
Practice Address - City:PITMAN
Practice Address - State:NJ
Practice Address - Zip Code:08071-1197
Practice Address - Country:US
Practice Address - Phone:267-939-4888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-02
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00978800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
00OtherN/A