Provider Demographics
NPI:1093009474
Name:SALCH, MATHEW A (MA LCPC LMHC)
Entity Type:Individual
Prefix:MR
First Name:MATHEW
Middle Name:A
Last Name:SALCH
Suffix:
Gender:M
Credentials:MA LCPC LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 NORTH ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-2264
Mailing Address - Country:US
Mailing Address - Phone:207-554-2600
Mailing Address - Fax:
Practice Address - Street 1:34 NORTH ST
Practice Address - Street 2:SUITE 6
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-2264
Practice Address - Country:US
Practice Address - Phone:207-554-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-03
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC4680101YP2500X
MEXL3855101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional