Provider Demographics
NPI:1396804696
Name:MATTHEWS, LASHAWN ANNETTE
Entity type:Individual
Prefix:MS
First Name:LASHAWN
Middle Name:ANNETTE
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 SPEARS DR
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:SC
Mailing Address - Zip Code:29045-8295
Mailing Address - Country:US
Mailing Address - Phone:803-238-0681
Mailing Address - Fax:
Practice Address - Street 1:907 SPEARS DR
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:SC
Practice Address - Zip Code:29045-8295
Practice Address - Country:US
Practice Address - Phone:803-238-0681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7893101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional