Provider Demographics
NPI:1114320736
Name:MATTHEWS, CHRISTINE (LSW MBA CLC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:LSW MBA CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200A HATFIELD ST
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-2324
Mailing Address - Country:US
Mailing Address - Phone:267-642-1470
Mailing Address - Fax:
Practice Address - Street 1:2303 N BROAD ST STE 4
Practice Address - Street 2:
Practice Address - City:COLMAR
Practice Address - State:PA
Practice Address - Zip Code:18915-9786
Practice Address - Country:US
Practice Address - Phone:267-642-1470
Practice Address - Fax:215-565-2581
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-28
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0193931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical