Provider Demographics
NPI:1386134740
Name:MATTHIAS, CASEY CHANDLER-ALEXANDER (MSE)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:CHANDLER-ALEXANDER
Last Name:MATTHIAS
Suffix:
Gender:F
Credentials:MSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 G ST APT 1
Mailing Address - Street 2:
Mailing Address - City:TURNERS FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:01376-1006
Mailing Address - Country:US
Mailing Address - Phone:413-992-8338
Mailing Address - Fax:
Practice Address - Street 1:108A N MAIN ST
Practice Address - Street 2:
Practice Address - City:SUNDERLAND
Practice Address - State:MA
Practice Address - Zip Code:01375-9502
Practice Address - Country:US
Practice Address - Phone:413-665-8717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-11
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker