Healthcare Provider Details

I. General information

NPI: 1407465933
Provider Name (Legal Business Name): COURTNEY RAE MATHEWS LCSW, LCAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2020
Last Update Date: 09/23/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 E JEFFERSON ST STE 101
FRANKLIN IN
46131-2586
US

IV. Provider business mailing address

550 E JEFFERSON ST STE 101
FRANKLIN IN
46131-2586
US

V. Phone/Fax

Practice location:
  • Phone: 317-738-0515
  • Fax:
Mailing address:
  • Phone: 317-738-0515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number87001410A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: