Provider Demographics
NPI:1760863534
Name:SCHATZ, MATTHEW BRENT (PHD, LCADC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:BRENT
Last Name:SCHATZ
Suffix:
Gender:M
Credentials:PHD, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 HIGHLAND TERR.
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20638
Mailing Address - Country:US
Mailing Address - Phone:301-908-1610
Mailing Address - Fax:
Practice Address - Street 1:308 HIGHLAND TERR.
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20638
Practice Address - Country:US
Practice Address - Phone:301-908-1610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA2111101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)