Provider Demographics
NPI:1548655434
Name:MATTHEW C SWARTZ
Entity type:Organization
Organization Name:MATTHEW C SWARTZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:SWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-880-2554
Mailing Address - Street 1:10100 WOLFRIVER DR
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-4543
Mailing Address - Country:US
Mailing Address - Phone:248-880-2554
Mailing Address - Fax:
Practice Address - Street 1:141 N CENTER ST
Practice Address - Street 2:SUITE 201
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48167-1483
Practice Address - Country:US
Practice Address - Phone:734-542-6969
Practice Address - Fax:734-542-6967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-30
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010972801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty