Provider Demographics
NPI:1912196163
Name:DISBROW, MATTHEW HARRINGTON (LCSW CACIII)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:HARRINGTON
Last Name:DISBROW
Suffix:
Gender:M
Credentials:LCSW CACIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7108 S ALTON WAY
Mailing Address - Street 2:BLDG A
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112
Mailing Address - Country:US
Mailing Address - Phone:303-694-3829
Mailing Address - Fax:
Practice Address - Street 1:7108 S ALTON WAY
Practice Address - Street 2:BLDG A
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112
Practice Address - Country:US
Practice Address - Phone:303-694-3829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4185101YA0400X
CO9922271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)