Provider Demographics
NPI:1083123889
Name:PLEIN, MATTHEW CHARLES
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:CHARLES
Last Name:PLEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 S MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-1975
Mailing Address - Country:US
Mailing Address - Phone:1248-529-6383
Mailing Address - Fax:
Practice Address - Street 1:1960 ROYAL AVE
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-4009
Practice Address - Country:US
Practice Address - Phone:248-535-2574
Practice Address - Fax:248-529-6383
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-25
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical