Healthcare Provider Details

I. General information

NPI: 1386579019
Provider Name (Legal Business Name): AALIYAH DENISE MATHIS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9020 OVERLOOK BLVD STE 130
BRENTWOOD TN
37027-3259
US

IV. Provider business mailing address

4800 N SCOTTSDALE RD STE 2500
SCOTTSDALE AZ
85251-7630
US

V. Phone/Fax

Practice location:
  • Phone: 865-588-3173
  • Fax:
Mailing address:
  • Phone: 865-588-3173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7040
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: