Provider Demographics
NPI:1407031990
Name:WELCH, MATTHEW H (MA, RMFTI)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:H
Last Name:WELCH
Suffix:
Gender:M
Credentials:MA, RMFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6123 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-3327
Mailing Address - Country:US
Mailing Address - Phone:727-815-3204
Mailing Address - Fax:727-815-3204
Practice Address - Street 1:6123 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-3327
Practice Address - Country:US
Practice Address - Phone:727-815-3204
Practice Address - Fax:727-815-3204
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT683106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist