Healthcare Provider Details

I. General information

NPI: 1285202564
Provider Name (Legal Business Name): MATTHEW ALAN TOWERS LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2021
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 COURT ST
BINGHAMTON NY
13901-3515
US

IV. Provider business mailing address

184 COURT ST
BINGHAMTON NY
13901-3515
US

V. Phone/Fax

Practice location:
  • Phone: 607-584-4465
  • Fax: 607-584-4480
Mailing address:
  • Phone: 607-584-4465
  • Fax: 607-584-4480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number097749
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: