Provider Demographics
NPI:1427371681
Name:MCLAUGHLIN, MATT (MFT, LEP)
Entity Type:Individual
Prefix:
First Name:MATT
Middle Name:
Last Name:MCLAUGHLIN
Suffix:
Gender:M
Credentials:MFT, LEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 WILLIAMSBURG LN
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2238
Mailing Address - Country:US
Mailing Address - Phone:530-520-2256
Mailing Address - Fax:
Practice Address - Street 1:341 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-5342
Practice Address - Country:US
Practice Address - Phone:530-520-2256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-02
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2682103T00000X
CA46218106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
27-1914297OtherEIN