Provider Demographics
NPI:1962791210
Name:STEINBACK, MATTHEW (MLADC, LADC, CCS)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:STEINBACK
Suffix:
Gender:M
Credentials:MLADC, LADC, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 DEWAYNS WAY
Mailing Address - Street 2:
Mailing Address - City:GORHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04038-2098
Mailing Address - Country:US
Mailing Address - Phone:828-230-5997
Mailing Address - Fax:
Practice Address - Street 1:341 MAIN ST
Practice Address - Street 2:
Practice Address - City:GORHAM
Practice Address - State:ME
Practice Address - Zip Code:04038-1309
Practice Address - Country:US
Practice Address - Phone:207-222-0181
Practice Address - Fax:207-222-0157
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-23750101YA0400X
MELC5193101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)