Individual
JULIET L MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1302 S ROGERS ST, BLOOMINGTON, IN 47403
(812) 353-2754
(812) 355-2327
Mailing address
1302 S ROGERS ST, BLOOMINGTON, IN 47403-4752
(812) 353-2754
(812) 355-2327
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
39000473A
IN
101YM0800X
Mental Health Counselor
Primary
39000473A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000316251
ANTHEM
—
01
—
000000572973
ANTHEM
IN
Enumeration date
03/04/2006
Last updated
05/08/2024
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