Provider Demographics
NPI:1871910513
Name:MATTHEWS, ELIZABETH (PSYD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:MATTHEWS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2710 N DODGE ST STE 1
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-8301
Mailing Address - Country:US
Mailing Address - Phone:319-400-1311
Mailing Address - Fax:
Practice Address - Street 1:2710 N DODGE ST STE 1
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-8301
Practice Address - Country:US
Practice Address - Phone:319-400-1311
Practice Address - Fax:319-575-6025
Is Sole Proprietor?:No
Enumeration Date:2014-03-19
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001372103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical