Provider Demographics
NPI:1629797436
Name:SPITZ, MATTHEW JONATHAN (MSW)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:JONATHAN
Last Name:SPITZ
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8105 OLYMPIA CT
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-6229
Mailing Address - Country:US
Mailing Address - Phone:954-695-3187
Mailing Address - Fax:
Practice Address - Street 1:8105 OLYMPIA CT
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-6229
Practice Address - Country:US
Practice Address - Phone:954-695-3187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health