Provider Demographics
NPI:1235587189
Name:MATTHEWS, KATHERINE (MFT-I)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:MFT-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8565 S EASTERN AVE
Mailing Address - Street 2:SUITE 116
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2808
Mailing Address - Country:US
Mailing Address - Phone:702-708-1081
Mailing Address - Fax:
Practice Address - Street 1:8565 S EASTERN AVE
Practice Address - Street 2:SUITE 116
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2808
Practice Address - Country:US
Practice Address - Phone:702-708-1081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20151065225106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist