Provider Demographics
NPI:1316574510
Name:DUNTON, MATTHEW M
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:M
Last Name:DUNTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:469 CENTERVILLE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-4355
Mailing Address - Country:US
Mailing Address - Phone:401-773-3700
Mailing Address - Fax:
Practice Address - Street 1:469 CENTERVILLE RD STE 101
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4355
Practice Address - Country:US
Practice Address - Phone:401-773-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-26
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW021121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIISW03236OtherLICENSED INDEPENDENT CLINICAL SOCIAL WORKER (LICSW)