Provider Demographics
NPI:1871785790
Name:MATHEWS, JOHN E (PSYD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:MATHEWS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:TOPSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01983-1718
Mailing Address - Country:US
Mailing Address - Phone:978-887-6173
Mailing Address - Fax:978-887-6173
Practice Address - Street 1:52 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TOPSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01983-1718
Practice Address - Country:US
Practice Address - Phone:978-887-6173
Practice Address - Fax:978-887-6173
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-14
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4095103G00000X, 103TC0700X, 103TC2200X, 103TH0100X, 103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAMA-W50626OtherMEDICARE B
MA0518441Medicaid