Basic Information
| Provider Information | |||||||||
| NPI: | 1508165556 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MATTHEWS | ||||||||
| FirstName: | ARNETTA | ||||||||
| MiddleName: | LILLIAN | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LPCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10912 THORNTON AVE | ||||||||
| Address2: | |||||||||
| City: | GARFIELD HEIGHTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441252742 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2162691896 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 22001 FAIMOUNT BOULEVARD | ||||||||
| Address2: | BELLEFAIRE JEWSH CHILDREN'S BUREAU | ||||||||
| City: | SHAKER HEIGHTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441184819 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2169322800 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2011 | ||||||||
| LastUpdateDate: | 02/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 0800321 | OH | N | Behavioral Health & Social Service Providers | Counselor | Professional | 101YP2500X | E.0800321 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.