Provider Demographics
NPI:1902061724
Name:HECHT-GIANUTSOS, MATTHEW N (LCSW)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:N
Last Name:HECHT-GIANUTSOS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2412 CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-4005
Mailing Address - Country:US
Mailing Address - Phone:718-681-8700
Mailing Address - Fax:
Practice Address - Street 1:2412 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-4005
Practice Address - Country:US
Practice Address - Phone:718-681-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0823031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01420795Medicaid