Healthcare Provider Details

I. General information

NPI: 1558935007
Provider Name (Legal Business Name): MATTHEW STEPHEN DOWNEY MSW, LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2021
Last Update Date: 05/19/2021
Certification Date: 05/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2907 E SMOKEY ROW RD
CARMEL IN
46033-9402
US

IV. Provider business mailing address

2907 E SMOKEY ROW RD
CARMEL IN
46033-9402
US

V. Phone/Fax

Practice location:
  • Phone: 317-846-0265
  • Fax:
Mailing address:
  • Phone: 317-846-0265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number34009248A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: