Provider Demographics
NPI:1861964769
Name:MATUZSAN, CAROLINE GRADY (MSW, LSW, CDE)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:GRADY
Last Name:MATUZSAN
Suffix:
Gender:F
Credentials:MSW, LSW, CDE
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:
Other - Last Name:GRADY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LSW
Mailing Address - Street 1:68 HARRISON AVE #605
Mailing Address - Street 2:PMB 62564
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111
Mailing Address - Country:US
Mailing Address - Phone:888-404-4813
Mailing Address - Fax:888-675-4061
Practice Address - Street 1:68 HARRISON AVE #605
Practice Address - Street 2:PMB 62564
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111
Practice Address - Country:US
Practice Address - Phone:888-404-4813
Practice Address - Fax:888-675-4061
Is Sole Proprietor?:No
Enumeration Date:2018-12-18
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSWB-2024-0287104100000X
PASW133517104100000X
174H00000X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No174H00000XOther Service ProvidersHealth Educator