Healthcare Provider Details

I. General information

NPI: 1740811579
Provider Name (Legal Business Name): HOLLY A MATHEWS PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2020
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 GREENBRIER CIR STE 503
CHESAPEAKE VA
23320-2663
US

IV. Provider business mailing address

860 GREENBRIER CIR STE 806
CHESAPEAKE VA
23320-2640
US

V. Phone/Fax

Practice location:
  • Phone: 757-861-9050
  • Fax: 757-861-9051
Mailing address:
  • Phone: 757-861-9050
  • Fax: 757-861-9051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810006384
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: