Provider Demographics
NPI:1740482314
Name:NACLERIO, MATTHEW (MSW)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:NACLERIO
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 WOOSTER ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-5711
Mailing Address - Country:US
Mailing Address - Phone:203-495-7555
Mailing Address - Fax:203-495-7557
Practice Address - Street 1:660 WINCHESTER AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-1969
Practice Address - Country:US
Practice Address - Phone:203-776-8390
Practice Address - Fax:203-773-0788
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health