Green, Matthew
Green, Matthew is an sole proprietor health care provider with primary practice located at 1208 Porter Wagoner Blvd Suite 4, West Plains MO 65775-1854. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Green, Matthew can be contacted via phone (417) 257-4031.Contact Information
Primary practice address
1208 Porter Wagoner Blvd Suite 4
West Plains MO 65775-1854
Phone: (417) 257-4031
Fax: (417) 256-4104
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X |
Profile Details
| NPI number | 1679697957 |
|---|---|
| LBN Legal business name | Green, Matthew |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 19th, 2007 |
| Last updated | Nov 3rd, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679697957 | NPPES |
| Missouri | MEDICAID | 499305423 |
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