Provider Demographics
NPI:1093573578
Name:GLOVER, MATTHEW (SOCIAL WORKER)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:GLOVER
Suffix:
Gender:M
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:844 VALLEY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44403-9654
Mailing Address - Country:US
Mailing Address - Phone:724-456-2191
Mailing Address - Fax:
Practice Address - Street 1:7529 WARREN SHARON RD
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:OH
Practice Address - Zip Code:44403-9796
Practice Address - Country:US
Practice Address - Phone:740-415-1138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1701598104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker