Provider Demographics
NPI:1295975530
Name:MATHEWSON, DEBBIE MARIE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:MARIE
Last Name:MATHEWSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 N CENTER RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638-5849
Mailing Address - Country:US
Mailing Address - Phone:989-401-8916
Mailing Address - Fax:
Practice Address - Street 1:355 N CENTER RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-5849
Practice Address - Country:US
Practice Address - Phone:989-401-8916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-26
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI730210101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0963095OtherBLUE CROSS BLUE SHIELD