Individual provider Active NPI

Matthew Maynard, M.A. MFT

  • Marriage & Family Therapist
  • Wyckoff, NJ
National Provider Identifier
1235532011
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1708 Issued in CT
Practice address
91 Edison St
Wyckoff, NJ 07481-2726
Phone
(978) 413-5142
NPI assigned
Oct 7, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1708 CT Primary
Marriage & Family Therapist 106H00000X 37FI00179800 NJ

Addresses

Primary practice location

91 Edison St
Wyckoff, NJ 07481-2726

Mailing address

91 Edison St
Wyckoff, NJ 07481-2726
Phone (978) 413-5142

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1708CTMDMarriage & Family Therapist
37FI00179800NJMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1235532011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 EDISON ST",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074812726",
            "telephone_number": "978-413-5142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 EDISON ST",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074812726",
            "telephone_number": "978-413-5142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "M.A. MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-07",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "1708",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NJ",
            "license": "37FI00179800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyckoff, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.