Provider Demographics
NPI:1457084543
Name:ROHRER, MATTHEW L (LCSW)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:L
Last Name:ROHRER
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 1:101 WYCKOFF AVE APT 3G
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-3389
Mailing Address - Country:US
Mailing Address - Phone:925-285-8543
Mailing Address - Fax:
Practice Address - Street 1:87 RICHARDSON ST STE 14
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-1319
Practice Address - Country:US
Practice Address - Phone:925-285-8543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0926861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical