Provider Demographics
NPI:1558397364
Name:MATTHEWS, HENRY MADDOX JR (LPC, CSAC)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:MADDOX
Last Name:MATTHEWS
Suffix:JR
Gender:M
Credentials:LPC, CSAC
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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
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2023-10-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0710101983101YA0400X
VA0701003879101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)