Individual
MR. DEWEY TRUMAN MATHERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
151 KINGS CREST CT, KINGS MTN, NC 28086-8218
(704) 730-8295
(704) 730-8295
Mailing address
151 KINGS CREST CT, KINGS MTN, NC 28086-8218
(704) 730-8295
(704) 730-8295
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C001231
NC
1041C0700X
Clinical Social Worker
Primary
C001231
NC
106H00000X
Marriage & Family Therapist
408
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54683
BC/BS PIN NUMBER
NC
05
—
6002095
—
NC
Enumeration date
06/14/2006
Last updated
01/25/2013
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