Provider Demographics
NPI:1295493153
Name:MATTICE, ALI-MARIE MURPHY (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ALI-MARIE
Middle Name:MURPHY
Last Name:MATTICE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 STARKLAND WAY
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-8730
Mailing Address - Country:US
Mailing Address - Phone:570-854-8532
Mailing Address - Fax:
Practice Address - Street 1:1501 HIGHWOODS BLVD STE 101
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2051
Practice Address - Country:US
Practice Address - Phone:336-272-0855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-07
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD248321041C0700X
NCC0163381041C0700X
NCP0169901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical