Healthcare Provider Details

I. General information

NPI: 1437491990
Provider Name (Legal Business Name): KAREN SUE MATTHEWS LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN SUE HANDLEY LMHC

II. Dates (important events)

Enumeration Date: 03/22/2013
Last Update Date: 04/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 CENTER POINT RD NE STE C
CEDAR RAPIDS IA
52402-5569
US

IV. Provider business mailing address

3525 CENTER POINT RD NE STE C
CEDAR RAPIDS IA
52402-5569
US

V. Phone/Fax

Practice location:
  • Phone: 319-200-4274
  • Fax:
Mailing address:
  • Phone: 319-200-4274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number001387
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier3708165
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: