Healthcare Provider Details

I. General information

NPI: 1780446567
Provider Name (Legal Business Name): HEALTH MATTERS, PLLC BEHAVIORAL HEALTH COUNSELING AND CONSULTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2024
Last Update Date: 01/26/2024
Certification Date: 01/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3540 CLEMMONS RD STE 110
CLEMMONS NC
27012-9395
US

IV. Provider business mailing address

3540 CLEMMONS RD STE 110
CLEMMONS NC
27012-9395
US

V. Phone/Fax

Practice location:
  • Phone: 336-515-0738
  • Fax: 336-232-1501
Mailing address:
  • Phone: 336-515-0738
  • Fax: 336-232-1501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

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

# 1
Identifier1740287937
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name: MRS. KAREN RENE' MAYNARD
Title or Position: MEMBER
Credential: LCSW
Phone: 336-515-0738