MEDICARE: MRS. TERRY HANSEN MATZ LCSW, LMSW

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	1041C0700X	Clinical Social Worker	CW014433	PA
2	1041C0700X	Clinical Social Worker	6801081553	MI

General Provider Information

NPI Number	:	1780657361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TERRY HANSEN MATZ LCSW, LMSW

Provider Business Mailing Address
First Line	:	108 W PROSPECT AVE
Second Line	:
City	:	RAEFORD
State	:	NC
Zip	:	28376-2632
Country	:	US
Telephone Number	:	910-907-6246
Fax Number	:	910-907-6571

Provider Business Practice Location Address
First Line	:	2917 REILLY RD
Second Line	:	MCXC-DSW
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-0001
Country	:	US
Telephone Number	:	910-907-6246
Fax Number	:	910-907-6571

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

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	09/11/2025

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