Provider Demographics
NPI:1194582460
Name:MOREAU, MATTHEW FREDERICK (LLMSW)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:FREDERICK
Last Name:MOREAU
Suffix:
Gender:M
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 N CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854-1017
Mailing Address - Country:US
Mailing Address - Phone:517-237-7412
Mailing Address - Fax:517-237-7420
Practice Address - Street 1:630 N CEDAR ST
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:MI
Practice Address - Zip Code:48854-1017
Practice Address - Country:US
Practice Address - Phone:517-237-7412
Practice Address - Fax:517-237-7420
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical