Provider Demographics
NPI:1851976625
Name:MATHEW, PRIYA (MS, LPC ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:MATHEW
Suffix:
Gender:F
Credentials:MS, LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1902 BROOKHILL DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-7613
Mailing Address - Country:US
Mailing Address - Phone:214-517-0046
Mailing Address - Fax:
Practice Address - Street 1:1902 BROOKHILL DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-7613
Practice Address - Country:US
Practice Address - Phone:214-517-0046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-13
Last Update Date:2021-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79411101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional