Provider Demographics
NPI:1487902227
Name:MATHEWS, ADAM (PHD, LMFT, LPC)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:MATHEWS
Suffix:
Gender:M
Credentials:PHD, LMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 DRY AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-3352
Mailing Address - Country:US
Mailing Address - Phone:318-791-6975
Mailing Address - Fax:
Practice Address - Street 1:120 DRY AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-3352
Practice Address - Country:US
Practice Address - Phone:318-791-6975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-28
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3857101YP2500X
LA1133106H00000X
NC1581106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional