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NPI Code Detail

MEDICARE: MS. PAULA JEAN MATTHEWS M.S.W., L.C.S.W.

MEDICARE: MS. PAULA JEAN MATTHEWS M.S.W., L.C.S.W.
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
1104100000XSocial Worker554-CAR

General Provider Information

NPI Number : 1225064280
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PAULA JEAN MATTHEWS M.S.W., L.C.S.W.
Provider Business Mailing Address
First Line : PO BOX 132
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72702-0132
Country : US
Telephone Number : 479-582-9020
Fax Number : 479-582-9020
Provider Business Practice Location Address
First Line : 111 E DAVIDSON ST
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72701-3413
Country : US
Telephone Number : 479-582-9020
Fax Number : 479-582-9020
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2006
Last Update Date : 07/08/2007

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