Provider Demographics
NPI:1336039486
Name:MATHERNE, GEVIN TROY
Entity type:Individual
Prefix:
First Name:GEVIN
Middle Name:TROY
Last Name:MATHERNE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:578 N ELK ST
Mailing Address - Street 2:
Mailing Address - City:GASSAWAY
Mailing Address - State:WV
Mailing Address - Zip Code:26624-1148
Mailing Address - Country:US
Mailing Address - Phone:304-804-3190
Mailing Address - Fax:
Practice Address - Street 1:266 SKIDMORE LN
Practice Address - Street 2:
Practice Address - City:SUTTON
Practice Address - State:WV
Practice Address - Zip Code:26601-9271
Practice Address - Country:US
Practice Address - Phone:304-765-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)