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General NPI Number Information
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NPI Number | 1922257955
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Entity Type | Organization
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Legal Business Name | MATHEWS PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 09/15/2008
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Last Update Date | 09/15/2008
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Provider Practice Location Address
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Address Line | 9640 N AUGUSTA DR SUITE 434
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City | CARMEL
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State | IN
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Zip | 46032-9600
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Country | US
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Telephone | 317-228-0566
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Fax | 317-228-0514
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Provider Business Mailing Address
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Address Line | 9640 N AUGUSTA DR SUITE 434
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City | CARMEL
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State | IN
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Zip | 46032-9600
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Country | US
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Telephone | 317-228-0566
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Fax | 317-228-0514
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. LAURA LYNNE MATHEWS
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Credential | PHD
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Telephone | 317-228-0566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 20041985A
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License Number State | IN
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