Provider Demographics
NPI:1235356593
Name:LOMBARD, MATTHEW K (LCSW)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:K
Last Name:LOMBARD
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 1:20 LINCOLN CIR
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04062-5566
Mailing Address - Country:US
Mailing Address - Phone:207-615-2292
Mailing Address - Fax:
Practice Address - Street 1:20 LINCOLN CIR
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:ME
Practice Address - Zip Code:04062-5566
Practice Address - Country:US
Practice Address - Phone:207-615-2292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC111751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical