Michael Roger Matthews, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

PRO01695-1 Issued in NY

Practice address

1430 Clove Road
Suite 1
Staten Island, NY 10301

Phone

(917) 613-2645

Fax

(966) 473-2390

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306939913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 VALENCIA AVENUE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10301",
            "telephone_number": "781-981-3790",
            "fax_number": "866-473-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 CLOVE ROAD",
            "address_2": "SUITE 1",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10301",
            "telephone_number": "917-613-2645",
            "fax_number": "966-473-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "MICHAEL",
        "middle_name": "ROGER",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PRO01695-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsy Yvonne Matthew
• Carolyn Matthews, RN
• Edward John Matthews Jr., MD
• Geraldine S Matthews, L.C.S.W.
• Jean S Matthews, M.S. SP. ED
• Melissa Matthey, CASACT
• Lisa G Mattia, RN
• Nicholas Anthony Mattia, D.D.S.
• Amy Mattielli, P.A.-C.
• Paul Louis Mattiola, RPH

• Clinical Social Worker in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.