Provider Demographics
NPI:1952772048
Name:JOHN MATHEWS LCSW, LLC
Entity Type:Organization
Organization Name:JOHN MATHEWS LCSW, LLC
Other - Org Name:VIRGINIA COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LCSW, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-317-5756
Mailing Address - Street 1:4581 LIFESTYLE LN
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-4807
Mailing Address - Country:US
Mailing Address - Phone:804-317-5756
Mailing Address - Fax:804-482-2590
Practice Address - Street 1:4581 LIFESTYLE LN
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-4807
Practice Address - Country:US
Practice Address - Phone:804-317-5756
Practice Address - Fax:804-510-0929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-14
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040089191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty