Provider Demographics
NPI:1871808634
Name:MICHAUD, MATTHEW A (LCSW)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:A
Last Name:MICHAUD
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:PO BOX 2701
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04116-2701
Mailing Address - Country:US
Mailing Address - Phone:207-749-1627
Mailing Address - Fax:
Practice Address - Street 1:TOUCHSTONE ASSOCIATES
Practice Address - Street 2:225 COMMERCIAL ST #300
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101
Practice Address - Country:US
Practice Address - Phone:207-749-1627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-17
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC32631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical