MEDICARE: MATTHEW COLLIN MA

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
1	101YM0800X	Mental Health Counselor	LMHC10000706	MA

General Provider Information

NPI Number	:	1063059442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW COLLIN MA

Provider Business Mailing Address
First Line	:	397 GROVE ST
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01605-1223
Country	:	US
Telephone Number	:	508-978-2773
Fax Number	:	508-791-3155

Provider Business Practice Location Address
First Line	:	397 GROVE ST
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01605-1223
Country	:	US
Telephone Number	:	508-978-2773
Fax Number	:	508-791-3677

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2019
Last Update Date	:	03/26/2026

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Directions to “ MATTHEW COLLIN MA” Practice Location

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