Healthcare Provider Details

I. General information

NPI: 1003549106
Provider Name (Legal Business Name): MATTHEW SCOTT SHELDON LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2022
Last Update Date: 12/05/2022
Certification Date: 12/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 WEST ST STE V
NEW MILFORD CT
06776-3525
US

IV. Provider business mailing address

2000 MAPLE HILL ST
YORKTOWN HEIGHTS NY
10598-4176
US

V. Phone/Fax

Practice location:
  • Phone: 860-799-5750
  • Fax: 860-969-1978
Mailing address:
  • Phone: 914-962-5101
  • Fax: 914-962-5102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number012357
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number005916
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: