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NPI Code Detail

MEDICARE: MR. MATHEW C GASS MSW, LCSW

MEDICARE: MR. MATHEW C GASS MSW, LCSW
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 Worker2008035090MO

General Provider Information

NPI Number : 1548587686
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MATHEW C GASS MSW, LCSW
Provider Business Mailing Address
First Line : 2885 W BATTLEFIELD ST
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65807-3952
Country : US
Telephone Number : 417-761-5214
Fax Number :
Provider Business Practice Location Address
First Line : 3401 BERRYWOOD DR
Second Line :
City : COLUMBIA
State : MO
Zip : 65201-8372
Country : US
Telephone Number : 573-777-8330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2010
Last Update Date : 05/02/2025

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