Provider Demographics
NPI:1538591797
Name:SMEKAR, MATTHEW D (LPC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:D
Last Name:SMEKAR
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5957 W OLMSTEAD RD
Mailing Address - Street 2:
Mailing Address - City:LUDINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49431-9754
Mailing Address - Country:US
Mailing Address - Phone:231-843-1339
Mailing Address - Fax:
Practice Address - Street 1:307 S JAMES ST
Practice Address - Street 2:SUITE 105
Practice Address - City:LUDINGTON
Practice Address - State:MI
Practice Address - Zip Code:49431-2105
Practice Address - Country:US
Practice Address - Phone:231-590-6652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401004634101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional