Provider Demographics
NPI:1609341478
Name:MAYER, MATTHEW SYLVAN (LADC II)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:SYLVAN
Last Name:MAYER
Suffix:
Gender:M
Credentials:LADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31A WORKSHOP RD
Mailing Address - Street 2:
Mailing Address - City:S YARMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02664-1210
Mailing Address - Country:US
Mailing Address - Phone:508-398-5155
Mailing Address - Fax:
Practice Address - Street 1:31A WORKSHOP RD
Practice Address - Street 2:
Practice Address - City:S YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02664-1210
Practice Address - Country:US
Practice Address - Phone:508-398-5155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-09
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)