NPIMap

Organization Active NPI

Dirty South Therapeutics LLC

  • Clinical Social Worker
  • Chillicothe, OH
National Provider Identifier
1194589408
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
DIRTY SOUTH THERAPEUTICS LLC
Practice address
77 E Water St Ste 217
Chillicothe, OH 45601-2586
Phone
(740) 701-2890
NPI assigned
Feb 7, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Daniel Ray Mathuews Jr., LISW-SNPI 1437650413
Title
Owner/Provider
Phone
(740) 701-2890

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary
Community Health WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 172V00000X

Addresses

Primary practice location

77 E Water St Ste 217
Chillicothe, OH 45601-2586

Mailing address

77 E Water St Ste 217
Chillicothe, OH 45601-2586
Phone (740) 701-2890

National Provider Directory

National Provider Directory
Tax ID family
Dirty South Therapeutics LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1707264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707264000000",
    "number": "1194589408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 E WATER ST STE 217",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456012586",
            "telephone_number": "740-701-2890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 E WATER ST STE 217",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456012586",
            "telephone_number": "740-701-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRTY SOUTH THERAPEUTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A",
        "authorized_official_last_name": "MATHUEWS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "740-701-2890",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LISW-S"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chillicothe, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.