Provider Demographics
NPI:1528454998
Name:NEEBE, MATTHEW COLLINS (LCSW, CASAC, CPP)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:COLLINS
Last Name:NEEBE
Suffix:
Gender:M
Credentials:LCSW, CASAC, CPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2879
Mailing Address - Country:US
Mailing Address - Phone:631-360-7578
Mailing Address - Fax:631-360-7687
Practice Address - Street 1:161 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2879
Practice Address - Country:US
Practice Address - Phone:631-360-7578
Practice Address - Fax:631-360-7687
Is Sole Proprietor?:No
Enumeration Date:2015-04-12
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18773101YA0400X
NY092557104100000X
NY2138405300000X
NY0868431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No405300000XOther Service ProvidersPrevention Professional