Provider Demographics
NPI:1245438712
Name:MATTHEWS, GLYNIS MACARTHUR (LPC)
Entity type:Individual
Prefix:MR
First Name:GLYNIS
Middle Name:MACARTHUR
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 CHESTERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29906-9006
Mailing Address - Country:US
Mailing Address - Phone:843-693-9306
Mailing Address - Fax:
Practice Address - Street 1:14 CHESTERFIELD DR
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29906-9006
Practice Address - Country:US
Practice Address - Phone:843-693-9306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2011-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4963101YM0800X
324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility