Provider Demographics
NPI:1659520062
Name:MATTHEWS, EVANGELINE D (LCSWA, LCASA)
Entity Type:Individual
Prefix:MR
First Name:EVANGELINE
Middle Name:D
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:LCSWA, LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8338 NC HIGHWAY 39 S
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27537-7132
Mailing Address - Country:US
Mailing Address - Phone:919-538-5459
Mailing Address - Fax:
Practice Address - Street 1:8338 NC HIGHWAY 39 S
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27537-7132
Practice Address - Country:US
Practice Address - Phone:919-538-5459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3558-A101YA0400X
NCP0071591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)