Provider Demographics
NPI:1114625597
Name:MEARES, MATTHEW HENRY (LCSW)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:HENRY
Last Name:MEARES
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 1:10239 KNOBOAK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-2909
Mailing Address - Country:US
Mailing Address - Phone:832-752-3124
Mailing Address - Fax:
Practice Address - Street 1:3313 DAMICO ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-1905
Practice Address - Country:US
Practice Address - Phone:281-972-6716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX679071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical