Provider Demographics
NPI:1407542475
Name:MATTHEWS COUNSELING & SUPERVISION
Entity Type:Organization
Organization Name:MATTHEWS COUNSELING & SUPERVISION
Other - Org Name:HENRY M MATTHEWS JR
Other - Org Type:Other Name
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAWANA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-250-8203
Mailing Address - Street 1:5821 STAPLES MILL RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-5427
Mailing Address - Country:US
Mailing Address - Phone:804-264-0966
Mailing Address - Fax:804-264-1029
Practice Address - Street 1:5821 STAPLES MILL RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23228-5427
Practice Address - Country:US
Practice Address - Phone:804-264-0966
Practice Address - Fax:804-264-1029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-13
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty