Provider Demographics
NPI:1093137119
Name:MCEUEN, MATTHEW R (LCSW)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:R
Last Name:MCEUEN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CHILDRENS WAY # 653
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-3500
Mailing Address - Country:US
Mailing Address - Phone:501-364-1100
Mailing Address - Fax:501-526-6562
Practice Address - Street 1:1301 WOLFE ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-5320
Practice Address - Country:US
Practice Address - Phone:501-364-1830
Practice Address - Fax:501-364-4931
Is Sole Proprietor?:No
Enumeration Date:2014-01-08
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR7931-C104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker