Provider Demographics
NPI:1588286561
Name:MATTEAU, LAUREN (LCSW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:MATTEAU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 MILL ST STE 200
Mailing Address - Street 2:
Mailing Address - City:EAST BERLIN
Mailing Address - State:CT
Mailing Address - Zip Code:06023-1159
Mailing Address - Country:US
Mailing Address - Phone:860-205-8015
Mailing Address - Fax:
Practice Address - Street 1:1224 MILL ST STE 200
Practice Address - Street 2:
Practice Address - City:EAST BERLIN
Practice Address - State:CT
Practice Address - Zip Code:06023-1159
Practice Address - Country:US
Practice Address - Phone:860-258-6060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-12
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical