Provider Demographics
NPI:1528256286
Name:READY, MATTHEW M (LMSW)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:M
Last Name:READY
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3940 PENINSULAR DR SE STE 230
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-6187
Mailing Address - Country:US
Mailing Address - Phone:616-458-0692
Mailing Address - Fax:231-722-6933
Practice Address - Street 1:2851 CHARLEVOIX DR SE STE 323
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-7092
Practice Address - Country:US
Practice Address - Phone:616-458-0692
Practice Address - Fax:616-458-8129
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010796671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOF16408033Medicare PIN