Provider Demographics
NPI:1619236049
Name:JARMAN, MATTHEW TODD (LICSW)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:TODD
Last Name:JARMAN
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 1:153 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:MA
Mailing Address - Zip Code:01516-2454
Mailing Address - Country:US
Mailing Address - Phone:774-482-0995
Mailing Address - Fax:
Practice Address - Street 1:153 MAIN ST
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:MA
Practice Address - Zip Code:01516-2454
Practice Address - Country:US
Practice Address - Phone:774-482-0995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-04
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
MA1258401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care Coordinator