MEDICARE: AMANDA MATHEWSON

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1427863315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA MATHEWSON

Provider Business Mailing Address
First Line	:	405 CHESTUEE RD NE
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37323-4515
Country	:	US
Telephone Number	:	423-303-6832
Fax Number	:

Provider Business Practice Location Address
First Line	:	2409 GEORGETOWN RD NW
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37311-3553
Country	:	US
Telephone Number	:	423-457-1907
Fax Number	:	844-580-4936

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2025
Last Update Date	:	12/29/2025

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Directions to “ AMANDA MATHEWSON ” Practice Location

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