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Individual

MR. CARMEN DOMINICK DEMATTEO JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW-C CAC-AD

Contact information

Practice address
421 FALLSWAY, BALTIMORE, MD 21202-4800
(443) 703-1139
(443) 703-1497
Mailing address
421 FALLSWAY, BALTIMORE, MD 21202-4800
(443) 703-1139
(443) 703-1497

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1041C0700X
Clinical Social Worker
Primary
14445
MD

Other

Enumeration date
08/14/2013
Last updated
08/14/2013
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