Individual
MR. DEWEY TRUMAN MATHERLY
Active
Individual
MR. DEWEY TRUMAN MATHERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
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
Update your record
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