Matthew Staley, LCSW

Clinical Social Worker · Lake Villa, IL

Individual Active NPI

NPI number 1770123671

Practice location

25480 W Cedar Crest Ln
Lake Villa, IL 60046-9744
Phone
(847) 356-8205

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NPI record

NPI
1770123671
Entity type
Individual (Type 1)
Enumeration date
January 9, 2020
Last updated
January 9, 2020
Certified
January 9, 2020
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Clinical Social Worker Primary 1041C0700X 149021089 IL

Mailing address

55 E Jackson Blvd Ste 1500
Chicago, IL 60604-4184

About Matthew Staley

Matthew Staley, LCSW is a healthcare provider registered in the NPI registry with the primary taxonomy Clinical Social Worker (code 1041C0700X). The practice location is 25480 W Cedar Crest Ln, Lake Villa, IL 60046-9744. The NPI number 1770123671 was assigned on January 9, 2020 and the record was last updated on January 9, 2020.

Matthew Staley lists a license in the registry: #149021089 (IL) for Clinical Social Worker. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Matthew Staley, LCSW?

The NPI number is 1770123671.

What is the phone number of Matthew Staley?

The phone number listed for the practice location is (847) 356-8205.

Where is Matthew Staley located?

25480 W Cedar Crest Ln, Lake Villa, IL 60046-9744.

What is the taxonomy code for Matthew Staley?

The primary taxonomy code is 1041C0700X – Clinical Social Worker.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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