Individual
MR. CHARLY MATHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
15321 S DIXIE HWY, SUITE 210, MIAMI, FL 33157-1814
(305) 259-0017
Mailing address
15321 S DIXIE HWY, SUITE 210, MIAMI, FL 33157-1814
(305) 259-0017
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
093684-01
NY
1041C0700X
Clinical Social Worker
7747
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
767212800
—
FL
Enumeration date
04/26/2007
Last updated
03/17/2023
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