| Life Matrix Nc Pllc | |
|
100 Hay St Ste 701 Fayetteville NC 28301-5487 | |
| (910) 444-1996 | |
| (800) 337-1933 |
| Full Name | Life Matrix Nc Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 100 Hay St Ste 701, Fayetteville, North Carolina |
| Authorized Official Name and Position | Debra M Johnson (CLINICAL DIRECTOR) |
| Authorized Official Contact | 9107977354 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Matrix Nc Pllc 100 Hay St Ste 701 Fayetteville NC 28301-5487 Ph: (910) 797-7354 | Life Matrix Nc Pllc 100 Hay St Ste 701 Fayetteville NC 28301-5487 Ph: (910) 444-1996 |
| NPI Number | 1134698509 |
|---|---|
| Provider Enumeration Date | 11/15/2018 |
| Last Update Date | 10/03/2023 |
| Certification Date | 10/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134698509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 171400000X | Health & Wellness Coach | (* (Not Available)) | Secondary |
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