Provider Demographics
NPI:1609356237
Name:MATTHEWS, KRISTIN (LICSW)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 EXETER RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:MA
Mailing Address - Zip Code:01749-3703
Mailing Address - Country:US
Mailing Address - Phone:978-562-1820
Mailing Address - Fax:
Practice Address - Street 1:161 WORCESTER RD STE 409
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-5300
Practice Address - Country:US
Practice Address - Phone:508-879-2093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1114131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical