Provider Demographics
NPI:1598504060
Name:MATT GIVENS COUNSELING SERVICES
Entity type:Organization
Organization Name:MATT GIVENS COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:GIVENS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:260-413-7333
Mailing Address - Street 1:237 AIRPORT NORTH OFFICE PARK
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-6702
Mailing Address - Country:US
Mailing Address - Phone:260-413-7333
Mailing Address - Fax:
Practice Address - Street 1:237 AIRPORT NORTH OFFICE PARK
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-6702
Practice Address - Country:US
Practice Address - Phone:260-413-7333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty