=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154235570
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | J L MATHENY SOLUTIONS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/01/2026
-----------------------------------------------------
Last Update Date | 10/01/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1132 ISHEE DR
-----------------------------------------------------
City | CLARKSVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37042
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 931-251-9722
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1477 TINY TOWN RD # 297
-----------------------------------------------------
City | CLARKSVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37042-7202
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 931-251-9722
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINICAL DIRECTOR/OWNER
-----------------------------------------------------
Name | MR. JAKAY MATHENY SR.
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 931-251-9722
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------