Provider Demographics
NPI:1295081529
Name:MATTHEWS, AARON LEE SR (LPC)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:LEE
Last Name:MATTHEWS
Suffix:SR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 SE 28TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-4268
Mailing Address - Country:US
Mailing Address - Phone:479-936-1645
Mailing Address - Fax:
Practice Address - Street 1:809 SE 28TH ST STE 1
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-4268
Practice Address - Country:US
Practice Address - Phone:479-936-1645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1502009101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional