Provider Demographics
NPI:1952781254
Name:MATTHEWS, JENNAFER CURTIS (LPC)
Entity Type:Individual
Prefix:
First Name:JENNAFER
Middle Name:CURTIS
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JENNAFER
Other - Middle Name:BROOKES
Other - Last Name:CURTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:429 GAMMON PL STE 200
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1053
Mailing Address - Country:US
Mailing Address - Phone:608-824-7243
Mailing Address - Fax:608-821-0938
Practice Address - Street 1:429 GAMMON PL STE 200
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1053
Practice Address - Country:US
Practice Address - Phone:608-824-7243
Practice Address - Fax:608-821-0938
Is Sole Proprietor?:No
Enumeration Date:2015-06-02
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WI7080-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health