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Individual
MR. MATTHEW LAWRENCE MONGILLO
Active
Individual
MR. MATTHEW LAWRENCE MONGILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA, AA, MHRS, RE
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
11/16/2006
Last updated
07/09/2025
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