Provider Demographics
NPI:1164570875
Name:MATTHEWS, BRIAN (LMFT)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5524 BEE CAVE RD
Mailing Address - Street 2:BUILDING I, SUITE 2
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5245
Mailing Address - Country:US
Mailing Address - Phone:512-314-5551
Mailing Address - Fax:
Practice Address - Street 1:5524 BEE CAVE RD
Practice Address - Street 2:BUILDING I, SUITE 2
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5245
Practice Address - Country:US
Practice Address - Phone:512-314-5551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX005108-005758106H00000X
CAMFC34805106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist