MEDICARE: MATRESCENT MIND, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1164375739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MATRESCENT MIND, PLLC

Provider Business Mailing Address
First Line	:	714 MICKELSON WAY
Second Line	:
City	:	LEBANON
State	:	TN
Zip	:	37087-5043
Country	:	US
Telephone Number	:	615-257-6064
Fax Number	:

Provider Business Practice Location Address
First Line	:	714 MICKELSON WAY
Second Line	:
City	:	LEBANON
State	:	TN
Zip	:	37087-5043
Country	:	US
Telephone Number	:	615-257-6064
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/THERAPIST
Name	:	MRS. STEPHANIE KATHRYN ADAMS
Credential	:	MA, LCPC, LPC-MHSP
Telephone Number	:	574-529-2226

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

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