Provider Demographics
NPI:1255196762
Name:LLOYD-MATTHEWS, DAWN K
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:K
Last Name:LLOYD-MATTHEWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 YUKON CT
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4162
Mailing Address - Country:US
Mailing Address - Phone:516-641-8419
Mailing Address - Fax:
Practice Address - Street 1:5 YUKON CT
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-4162
Practice Address - Country:US
Practice Address - Phone:516-641-8419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-14
Last Update Date:2024-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO548831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical