Provider Demographics
NPI:1851275150
Name:MATHEWS, DEMETRICA (LMFT)
Entity type:Individual
Prefix:
First Name:DEMETRICA
Middle Name:
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 WIDEWATERS PARKWAY,
Mailing Address - Street 2:UNIT A, STE 135
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545
Mailing Address - Country:US
Mailing Address - Phone:910-502-0729
Mailing Address - Fax:
Practice Address - Street 1:3330 STONEY HILL CHURCH RD
Practice Address - Street 2:
Practice Address - City:BAILEY
Practice Address - State:NC
Practice Address - Zip Code:27807-9060
Practice Address - Country:US
Practice Address - Phone:919-703-3192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01158106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist