Provider Demographics
NPI:1831972769
Name:WELCH, MATTHEW TODD
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:TODD
Last Name:WELCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 N SHENANDOAH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-3555
Mailing Address - Country:US
Mailing Address - Phone:540-252-4997
Mailing Address - Fax:540-551-3294
Practice Address - Street 1:920 N SHENANDOAH AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-3555
Practice Address - Country:US
Practice Address - Phone:540-252-4997
Practice Address - Fax:540-551-3294
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040156811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical