Provider Demographics
NPI:1861213647
Name:MATZ, DANIELA (LCSW)
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:MATZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 SWISS LAKE DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-4792
Mailing Address - Country:US
Mailing Address - Phone:217-979-3004
Mailing Address - Fax:
Practice Address - Street 1:3040 HAMMOND BUSINESS PL # 105
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-3666
Practice Address - Country:US
Practice Address - Phone:919-899-6259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0119621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical