Smith, Matthew John
Smith, Matthew John is an individual health care provider with primary practice located at 610 Wampanoag Trl , Riverside RI 02915-1504. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Smith, Matthew John can be contacted via phone (401) 431-9870.Contact Information
Primary practice address
610 Wampanoag Trl
Riverside RI 02915-1504
Phone: (401) 431-9870
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | ISW00312 | Rhode Island |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | SW110857 | Massachusetts |
Profile Details
| NPI number | 1588773287 |
|---|---|
| LBN Legal business name | Smith, Matthew John |
| Credentials | LICSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 29th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588773287 | NPPES |
| Rhode Island | Other | 3005223 | BLUE CROSS |
| Rhode Island | MEDICAID | MS05223 | BLUE CROSS |
| Rhode Island | Other | 6236942 | BLUE CROSS |
| Rhode Island | Other | 407869 | BLUE CROSS |
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