Individual
MR. EDEM MATTHIAS EXCELLENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LCSW-A
Contact information
Practice address
432 EAST LONG AVENUE, SUITE 2, GASTONIA, NC 28054-2540
(980) 416-3025
(980) 448-3419
Mailing address
11125 HAZEL GARDENS DRIVE, CHARLOTTE, NC 28278-7942
(980) 416-3025
(980) 448-3419
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
P015897
NC
Other
Enumeration date
03/09/2021
Last updated
01/17/2025
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