Individual
MATHEW PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
415 E MADISON ST, SOUTH BEND, IN 46617-2322
(574) 533-1234
(574) 537-2652
Mailing address
330 LAKEVIEW DR, GOSHEN, IN 46528-7000
(574) 533-1234
(574) 537-2652
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34008869A
IN
Other
Enumeration date
08/06/2020
Last updated
08/06/2020
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