Provider Demographics
NPI:1396159018
Name:SCHWEYER, MATTHEW (LICDC-CS)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:SCHWEYER
Suffix:
Gender:M
Credentials:LICDC-CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4382 TOWNSHIP ROAD 27
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:OH
Mailing Address - Zip Code:45817-9646
Mailing Address - Country:US
Mailing Address - Phone:419-236-6969
Mailing Address - Fax:
Practice Address - Street 1:2238 N WEST ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-2038
Practice Address - Country:US
Practice Address - Phone:419-224-8000
Practice Address - Fax:419-998-5615
Is Sole Proprietor?:No
Enumeration Date:2014-06-20
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLICDC-CS 933479101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)