Provider Demographics
NPI:1295493153
Name:MATTICE, ALI-MARIE MURPHY (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ALI-MARIE
Middle Name:MURPHY
Last Name:MATTICE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 SIERRA LN
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32327-1381
Mailing Address - Country:US
Mailing Address - Phone:570-854-8532
Mailing Address - Fax:
Practice Address - Street 1:119 SW MAYNARD RD STE 200
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4472
Practice Address - Country:US
Practice Address - Phone:570-854-8532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-07
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD248321041C0700X
NCP0169901041C0700X
FLSW235901041C0700X
NCC0163381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical