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Individual

KARISSA MATTHEWS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMHP, PLADC, LPCC

Contact information

Practice address
8610 BRENTWOOD DR STE 1, LA VISTA, NE 68128-3377
(402) 331-3232
(402) 331-1557
Mailing address
7590 ANDASOL ST, SAN DIEGO, CA 92126-1017
(858) 204-4136

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
10573
NE
101YM0800X
Mental Health Counselor
Primary
4825
CA
101YM0800X
Mental Health Counselor
4896
NE

Other

Enumeration date
06/29/2015
Last updated
04/23/2018
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