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NPI Code Detail

MEDICARE: MATTHEW REED MACAULAY LICSW

MEDICARE: MATTHEW REED MACAULAY LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker089-0134176VT

General Provider Information

NPI Number : 1346706074
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW REED MACAULAY LICSW
Provider Business Mailing Address
First Line : 263 ELM ST
Second Line :
City : NORTH BENNINGTON
State : VT
Zip : 05257-9196
Country : US
Telephone Number : 908-705-6751
Fax Number :
Provider Business Practice Location Address
First Line : 5 BANK ST
Second Line :
City : NORTH BENNINGTON
State : VT
Zip : 05257-9102
Country : US
Telephone Number : 908-705-6751
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2019
Last Update Date : 12/13/2022

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Directions to “ MATTHEW REED MACAULAY LICSW” Practice Location

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