Provider Demographics
NPI:1104683259
Name:MATHEWS, CHRISTOPHER IRVING JR (LCSW)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:IRVING
Last Name:MATHEWS
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3398 WETHERBURNS CIR
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-3014
Mailing Address - Country:US
Mailing Address - Phone:901-409-2291
Mailing Address - Fax:
Practice Address - Street 1:293 S WALNUT BEND RD
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-7284
Practice Address - Country:US
Practice Address - Phone:901-206-5604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000081851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical