Provider Demographics
NPI:1184231854
Name:NEAL, MATTHEW C (CT CDCA)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:C
Last Name:NEAL
Suffix:
Gender:M
Credentials:CT CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7344 PEARL RD STE 2B
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-9602
Mailing Address - Country:US
Mailing Address - Phone:440-625-0081
Mailing Address - Fax:440-625-0053
Practice Address - Street 1:7344 PEARL RD STE 2B
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-9602
Practice Address - Country:US
Practice Address - Phone:440-625-0081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-28
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.173389101YA0400X
OHC.2002619-TRNE101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)