Individual
KYLE MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
600 JACKSON ST, FREDERICKSBURG, VA 22401-5719
(610) 373-3223
Mailing address
26 GLEN OAK RD, FREDERICKSBURG, VA 22405-1773
(610) 772-3124
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904018708
VA
Other
Enumeration date
07/14/2025
Last updated
07/14/2025
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