Provider Demographics
NPI:1346804879
Name:MATHEWSON, JAMIE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:MATHEWSON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13815 NORTHCREST RD
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-2448
Mailing Address - Country:US
Mailing Address - Phone:240-520-2237
Mailing Address - Fax:
Practice Address - Street 1:13815 NORTHCREST RD
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-2448
Practice Address - Country:US
Practice Address - Phone:240-520-2237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21222104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker