Provider Demographics
NPI:1407620578
Name:MATHEWS, ALLISON POINDEXTER (LCMHC-A)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:POINDEXTER
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 HAIRE RD
Mailing Address - Street 2:
Mailing Address - City:YADKINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27055-5153
Mailing Address - Country:US
Mailing Address - Phone:336-971-5005
Mailing Address - Fax:336-436-9123
Practice Address - Street 1:163 STRATFORD CT STE 170
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1833
Practice Address - Country:US
Practice Address - Phone:336-831-4051
Practice Address - Fax:336-436-9123
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16396101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health