Provider Demographics
NPI:1881239440
Name:GROTSKY, MATTHEW (LCMHC, LCASA)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:GROTSKY
Suffix:
Gender:M
Credentials:LCMHC, LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6135 PARK SOUTH DR SUITE 510
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210
Mailing Address - Country:US
Mailing Address - Phone:828-606-9129
Mailing Address - Fax:
Practice Address - Street 1:223 E CHESTNUT ST STE 4
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2480
Practice Address - Country:US
Practice Address - Phone:828-400-6299
Practice Address - Fax:828-484-4912
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-07
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-26133101YA0400X
NCA15357101YM0800X, 101YP2500X
NC15357101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health