Provider Demographics
NPI:1467291104
Name:TRATNER, MATTHEW JARRETT (LMSW)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:JARRETT
Last Name:TRATNER
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 1:511 W 44TH ST APT 8K
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-4171
Mailing Address - Country:US
Mailing Address - Phone:917-833-7163
Mailing Address - Fax:
Practice Address - Street 1:511 W 44TH ST APT 8K
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-4171
Practice Address - Country:US
Practice Address - Phone:917-833-7163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY117167-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker