Provider Demographics
NPI:1497895577
Name:MATTHEWS, ANN MAUREEN (PMHP & PMSW)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:MAUREEN
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:PMHP & PMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3241 C ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4521
Mailing Address - Country:US
Mailing Address - Phone:402-770-6945
Mailing Address - Fax:
Practice Address - Street 1:301 S 13TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-2537
Practice Address - Country:US
Practice Address - Phone:402-476-3002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6126-PROVISIONAL101YM0800X
NE6533-PROVISIONAL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker