Individual provider Active NPI

Allison Poindexter Mathews, LCMHC-A

  • Mental Health Counselor
  • Winston Salem, NC
National Provider Identifier
1407620578
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A16396 Issued in NC
Practice address
163 Stratford CT Ste 170
Winston Salem, NC 27103-1833
Phone
(336) 831-4051
Fax
(336) 436-9123
NPI assigned
Nov 9, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X A16396 NC Primary

Addresses

Primary practice location

163 Stratford CT Ste 170
Winston Salem, NC 27103-1833

Mailing address

1425 Haire Rd
Yadkinville, NC 27055-5153
Phone (336) 971-5005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 2, 2026 through Jul 2, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A16396NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1699488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1407620578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 HAIRE RD",
            "city": "YADKINVILLE",
            "state": "NC",
            "postal_code": "270555153",
            "telephone_number": "336-971-5005",
            "fax_number": "336-436-9123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 STRATFORD CT STE 170",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031833",
            "telephone_number": "336-831-4051",
            "fax_number": "336-436-9123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEWS",
        "first_name": "ALLISON",
        "middle_name": "POINDEXTER",
        "name_prefix": "Mrs.",
        "credential": "LCMHC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-09",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A16396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.