Individual
MR. BRAD TODD MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LISAC, CDVC
Contact information
Practice address
1750 S WOODLANDS VILLAGE BLVD STE 135, FLAGSTAFF, AZ 86001-2699
(602) 685-6000
(928) 679-2181
Mailing address
3003 N CENTRAL AVE STE 400, PHOENIX, AZ 85012-2929
(602) 685-6000
(928) 679-2199
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC1135
AZ
Other
Enumeration date
09/14/2012
Last updated
11/07/2023
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