Provider Demographics
NPI:1467761726
Name:LAUZON, MATTHEW D (MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:D
Last Name:LAUZON
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 SW 6TH AVE STE 1000
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97204-1345
Mailing Address - Country:US
Mailing Address - Phone:503-334-3035
Mailing Address - Fax:503-961-9212
Practice Address - Street 1:811 SW 6TH AVE STE 1000
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97204-1345
Practice Address - Country:US
Practice Address - Phone:503-334-3035
Practice Address - Fax:503-961-9212
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR46221041C0700X
ORL4622261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)