Provider Demographics
NPI:1598163883
Name:GUZZETTI, MATTHEW
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:GUZZETTI
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 1:20 N MAIN ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06854-2656
Mailing Address - Country:US
Mailing Address - Phone:203-838-6508
Mailing Address - Fax:203-852-7021
Practice Address - Street 1:20 N MAIN ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06854-2656
Practice Address - Country:US
Practice Address - Phone:203-838-6508
Practice Address - Fax:203-852-7021
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-18
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001007101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)