Most Relevant Information
Provider Data
| NPI Number: | 1003570615 |
| Provider Name: | MATTHEW M MIDKIFF LPC, MHSP |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | 5599 |
Most Important Dates
| Enumeration Date: | 10/29/2021 |
| Last Updated: | 01/20/2023 |
Provider Practice Location
109 W WATAUGA AVE
JOHNSON CITY
TN
376045621
Practice Location Phone/Fax
| Phone: | 4232322600 |
| Fax: | 4234673644 |
Provider Mailing Location
1167 SPRATLIN PARK DR
GRAY
TN
376156205
Provider Mailing Phone/Fax
| Phone: | 4234673600 |
| Fax: | 4234673644 |