Provider Demographics
NPI:1205574266
Name:NAPLES, MATTHEW CHET (LMSW)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:CHET
Last Name:NAPLES
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6208 N PARK MEADOW WAY APT 203
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83713-1657
Mailing Address - Country:US
Mailing Address - Phone:609-273-8754
Mailing Address - Fax:
Practice Address - Street 1:1993 E 8TH N
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:ID
Practice Address - Zip Code:83647-2326
Practice Address - Country:US
Practice Address - Phone:208-587-7626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-42214104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDLMSW-42214Medicaid