Provider Demographics
NPI:1467700971
Name:MATT SWEET MSW PC
Entity Type:Organization
Organization Name:MATT SWEET MSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:W
Authorized Official - Last Name:SWEET
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:248-930-2137
Mailing Address - Street 1:25600 WOODWARD AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-0943
Mailing Address - Country:US
Mailing Address - Phone:248-930-2137
Mailing Address - Fax:248-584-3334
Practice Address - Street 1:25600 WOODWARD AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-0943
Practice Address - Country:US
Practice Address - Phone:248-930-2137
Practice Address - Fax:248-584-3334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801086967101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty