Provider Demographics
NPI:1861857492
Name:MATTHEWS, NORA (LPCC)
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2665 4TH AVE STE 20
Mailing Address - Street 2:
Mailing Address - City:ANOKA
Mailing Address - State:MN
Mailing Address - Zip Code:55303-6629
Mailing Address - Country:US
Mailing Address - Phone:612-481-1198
Mailing Address - Fax:844-803-2643
Practice Address - Street 1:2665 4TH AVE STE 20
Practice Address - Street 2:
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-6629
Practice Address - Country:US
Practice Address - Phone:612-481-1198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-26
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00956101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional