Basic Information
Provider Information
NPI: 1447625553
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PLOSZYNSKI
FirstName: MATEUSZ
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LMFT, M.ED, LCPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1501 HUGHES WAY
Address2: SUITE 150
City: LONG BEACH
State: CA
PostalCode: 908101876
CountryCode: US
TelephoneNumber: 3102216336
FaxNumber:  
Practice Location
Address1: 1200 N MAIN
Address2: SUITE 100 B
City: SANTA ANA
State: CA
PostalCode: 92701
CountryCode: US
TelephoneNumber: 7144806650
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/01/2015
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000X88670CAN Behavioral Health & Social Service ProvidersMarriage & Family Therapist 
106H00000X94989CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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