Doctor Name: | MATTHEW BERNARD CARLETON |
NPI Number: | 1003917188 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LISW |
License Number: | I.0009478 |
Business Practice Address: | 205 W 20th St Lorain, OH - 440523779 |
Business Phone Number: | 4402443833 |
Business Fax Number: | |
Mailing Address: | 328 Walworth Ave, EUCLID |
State: | OH |
Postal Code: | 441321028 |
Phone Number: | 2167323456 |
Fax Number: | |
NPI Enumeration Date: | 09/25/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | I.0009478 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |