Provider Demographics
NPI:1023599180
Name:MATTHEWS, STEPHANIE M (MSW, LSW)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:M
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:M
Other - Last Name:SCHAEFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 W 9TH ST
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-2514
Mailing Address - Country:US
Mailing Address - Phone:812-996-8478
Mailing Address - Fax:812-996-0214
Practice Address - Street 1:800 W 9TH ST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-2514
Practice Address - Country:US
Practice Address - Phone:812-996-0437
Practice Address - Fax:812-996-0439
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33008733A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker