Individual provider · Type 1 NPI
Bernard Anthony Matherne Jr., MS, ICADCII
Addiction (Substance Use Disorder) Counselor · Lucedale, MS
NPI number
1871115089
Active
Practice location
226 Lowe Lane
Lucedale, MS 39452-4313
Fax (601) 791-5140
Mailing address
226 Lowe Ln
Lucedale, MS 39452-4313
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | AD97-025M (MS) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
About NPI 1871115089
Bernard Anthony Matherne Jr., MS, ICADCII's National Provider Identifier is 1871115089, issued on May 11, 2020. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Lucedale, MS. The record was last updated on May 11, 2020.