Provider Demographics
NPI:1073938833
Name:MATHEWS, CAROLYN C (PSYD, LMHC)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:C
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:PSYD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 UNIVERSITY ST
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2519
Mailing Address - Country:US
Mailing Address - Phone:206-618-1738
Mailing Address - Fax:
Practice Address - Street 1:411 UNIVERSITY ST
Practice Address - Street 2:SUITE 1200
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2519
Practice Address - Country:US
Practice Address - Phone:206-618-1738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-03
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60436292101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health