Provider Demographics
NPI:1548755952
Name:MATTHEWS, CLINTON TIMOTHY (LPCA)
Entity Type:Individual
Prefix:
First Name:CLINTON
Middle Name:TIMOTHY
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 LAKEVIEW ST
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-9691
Mailing Address - Country:US
Mailing Address - Phone:828-400-5674
Mailing Address - Fax:
Practice Address - Street 1:233 S FRENCH BROAD AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-3901
Practice Address - Country:US
Practice Address - Phone:828-254-0749
Practice Address - Fax:828-254-0762
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-27
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA13253101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health