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NPI Code Detail

MEDICARE: STEFAN MATTHEWS

MEDICARE: STEFAN MATTHEWS
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
1106S00000XBehavior Technician011307154LA
2103K00000XBehavior AnalystL-984LA

General Provider Information

NPI Number : 1841847712
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEFAN MATTHEWS
Provider Business Mailing Address
First Line : 105 DOGWOOD DR
Second Line :
City : LAFAYETTE
State : LA
Zip : 70501-3109
Country : US
Telephone Number : 337-446-6845
Fax Number :
Provider Business Practice Location Address
First Line : 17520 OLD JEFFERSON HWY
Second Line :
City : PRAIRIEVILLE
State : LA
Zip : 70769-3903
Country : US
Telephone Number : 225-300-6710
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2019
Last Update Date : 05/19/2025

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Directions to “ STEFAN MATTHEWS ” Practice Location

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