Healthcare Provider Details

I. General information

NPI: 1689491888
Provider Name (Legal Business Name): CURTIS MATTHEWS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2024
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 N POINT PKWY
ALPHARETTA GA
30022-2409
US

IV. Provider business mailing address

2526 OLD LOST MOUNTAIN RD
POWDER SPRINGS GA
30127-1431
US

V. Phone/Fax

Practice location:
  • Phone: 678-762-0370
  • Fax:
Mailing address:
  • Phone: 708-639-8118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: