Healthcare Provider Details

I. General information

NPI: 1932013893
Provider Name (Legal Business Name): MATTHEW TAYLOR WATKINS LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 4TH ST SW STE 102
HICKORY NC
28602-2872
US

IV. Provider business mailing address

401 4TH ST SW STE 102
HICKORY NC
28602-2872
US

V. Phone/Fax

Practice location:
  • Phone: 828-269-0773
  • Fax: 800-887-8477
Mailing address:
  • Phone: 828-269-0773
  • Fax: 800-887-8477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC014957
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: