Matthew Lamonte Allen Sr., LLMFT
Individual provider Active NPI Marriage & Family Therapist · Detroit, MI
NPI 1760036255 · NPPES record last updated Jan 15, 2021
Key facts
- NPI
- 1760036255
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 4151000424 (MI)
- Practice address
- 12800 E Warren Ave
Detroit, MI 48215-2061 - Phone
- (313) 308-1400
- NPI assigned
- Aug 1, 2019
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4151000424 | MI | MD | Marriage & Family Therapist |
Interoperability endpoints
- mallen@neguidance.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 4151000424 | MI | Yes |
Addresses
Primary practice location
12800 E Warren Ave
Detroit, MI 48215-2061
Mailing address
4840 Sheridan St
Detroit, MI 48214-5301
Phone (313) 878-4247
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4101006886 | Other | MI | LICENSE NUMBER |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Mallen@neguidance.org |
Other providers in Detroit, MI
- Kim Allen
- La'Paris Allen
- Laronda Morenike Allen
- Latoya Allen
- Lea Allen
- Melissa Laura Allen
- Mellanee Allen
- Michael John Allen
- Nakia Venise Allen
- Rachel Theresa Allen
All providers in Detroit, MI · Marriage & Family Therapist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.