Provider Demographics
NPI:1073682977
Name:MATTHEWS, MEG (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:MEG
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 HIGH ST STE 10
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-3848
Mailing Address - Country:US
Mailing Address - Phone:617-678-1273
Mailing Address - Fax:
Practice Address - Street 1:10 HIGH ST STE 10
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-3848
Practice Address - Country:US
Practice Address - Phone:781-395-1560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1111471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical