Matthew Staley, LCSW

NPI #1770123671 in Lake Villa, Illinois

Provider Information

NPI Number: 1770123671
Entity Type: Individual
Name: Matthew Staley, LCSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Credential: LCSW
Enumeration Date: Jan 9, 2020
Last Updated: Jan 9, 2020

Practice Location

Address: 25480 W CEDAR CREST LN
City: Lake Villa
State: Illinois
ZIP Code: 60046-9744
Phone: (847) 356-8205

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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