Provider Demographics
NPI:1285343392
Name:COMEAUX, MATTHEW WAYNE (MSW, CSW)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:WAYNE
Last Name:COMEAUX
Suffix:
Gender:M
Credentials:MSW, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2704 VICTORIA DR
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-6042
Mailing Address - Country:US
Mailing Address - Phone:504-338-4395
Mailing Address - Fax:
Practice Address - Street 1:990 N CORPORATE DR STE 101
Practice Address - Street 2:
Practice Address - City:HARAHAN
Practice Address - State:LA
Practice Address - Zip Code:70123-3331
Practice Address - Country:US
Practice Address - Phone:504-349-8833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17578104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker