Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 2020-000390 | NJ |
N | 101YM0800X | Mental Health Counselor | 2020-000390 | NJ |
NPI | 1003414939 |
---|---|
Provider Name | Matthew Steven Behrens |
First Address | Eatontown, NJ 07724-2953 |
Second Address | Eatontown, NJ 07724-4247 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2020 |
Last Update Date | 13/10/2020 |