Provider Demographics
NPI:1205625209
Name:COKE, MATTHEW JEREMIAH (MSW)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:JEREMIAH
Last Name:COKE
Suffix:
Gender:
Credentials:MSW
Other - Prefix:MR
Other - First Name:MATTHEW
Other - Middle Name:J
Other - Last Name:COKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:1258 FERNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MCKINLEYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95519-3423
Mailing Address - Country:US
Mailing Address - Phone:707-388-8012
Mailing Address - Fax:
Practice Address - Street 1:1258 FERNWOOD DR
Practice Address - Street 2:
Practice Address - City:MCKINLEYVILLE
Practice Address - State:CA
Practice Address - Zip Code:95519-3423
Practice Address - Country:US
Practice Address - Phone:707-388-8012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical