Mathis, Kathryn Grim

Mathis, Kathryn Grim is an individual health care provider with primary practice located at 305 E Main St , Elizabeth City NC 27909-4425. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Mathis, Kathryn Grim can be contacted via phone (252) 335-9400.

Contact Information

Primary practice address
305 E Main St Elizabeth City NC 27909-4425
Phone: (252) 335-9400
Fax: (252) 335-9404
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1124 North Carolina

Profile Details

NPI number 1790826790
LBN Legal business name Mathis, Kathryn Grim
Credentials LCAS, CSI
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 11th, 2007
Last updated Sep 24th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790826790 NPPES
North Carolina MEDICAID 6111930

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