Individual provider · Type 1 NPI
Brad Todd Mattingly, MA, LISAC, CDVC
Addiction (Substance Use Disorder) Counselor · Flagstaff, AZ
NPI number
1386994564
Active
Practice location
1750 S Woodlands Village Blvd Ste 135
Flagstaff, AZ 86001-2699
Fax (928) 679-2181
Mailing address
3003 N Central Ave Ste 400
Phoenix, AZ 85012-2929
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | LISAC1135 (AZ) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
Another provider at this address
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About NPI 1386994564
Brad Todd Mattingly, MA, LISAC, CDVC's National Provider Identifier is 1386994564, issued on Sep 14, 2012. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Flagstaff, AZ. The record was last updated on Nov 7, 2023.