Provider Demographics
NPI:1205654654
Name:MATHEWS FAMILY COUNSELING LLC
Entity type:Organization
Organization Name:MATHEWS FAMILY COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:DUANE
Authorized Official - Last Name:MATHEWS
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPCC
Authorized Official - Phone:440-201-4841
Mailing Address - Street 1:1507 LOVERS LN NW
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44485-2016
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1507 LOVERS LN NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44485-2016
Practice Address - Country:US
Practice Address - Phone:440-201-4841
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-02
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health