Provider Demographics
NPI:1487060935
Name:MATTHEWS, ADRIAN (LCSW-A)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:ADRIANNE
Other - Middle Name:
Other - Last Name:MATTHEWS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW-A
Mailing Address - Street 1:3745 BISON HILL LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-5008
Mailing Address - Country:US
Mailing Address - Phone:910-286-0249
Mailing Address - Fax:
Practice Address - Street 1:3745 BISON HILL LN
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-5008
Practice Address - Country:US
Practice Address - Phone:910-286-0249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-05
Last Update Date:2014-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP008734251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health