NPIMap

Organization Active NPI

Authentic Counseling Associates - a Psychological Corporation

  • Psychologist
  • Gold River, CA
National Provider Identifier
1003165846
Registry record updated Sep 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
AUTHENTIC COUNSELING ASSOCIATES - A PSYCHOLOGICAL CORPORATION
Practice address
11344 Coloma Rd
Suite 435
Gold River, CA 95670-4457
Phone
(916) 709-1170
NPI assigned
Sep 7, 2012
Last updated
Sep 7, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2012

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

Authorized official

Name
Dr. Christopher Lewis Mathe, PHDNPI 1568756799
Title
Clinical Director
Phone
(916) 709-1170

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU Primary

Addresses

Primary practice location

11344 Coloma Rd
Suite 435
Gold River, CA 95670-4457

Mailing address

11344 Coloma Rd
Suite 435
Gold River, CA 95670-4457
Phone (916) 709-1170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130718000560 CA Part B Supplier - Clinic/Group Practice 4486895315 Receives reassigned benefits from 4 practitioners
Practice locations: Auburn, CA; Gold River, CA; Sacramento, CA

National Provider Directory

National Provider Directory

Locations

701 High St
Ste 227
Auburn, CA 95603
Phone (530) 500-5885

11344 Coloma Rd
Ste 435
Gold River, CA 95670
Phone (916) 546-8071

11344 Coloma Rd
Ste 515
Gold River, CA 95670
Phone (916) 524-6064

11344 Coloma Rd
Ste 605
Gold River, CA 95670
Phone (916) 709-1170

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1346976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346976000000",
    "number": "1003165846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11344 COLOMA RD",
            "address_2": "SUITE 435",
            "city": "GOLD RIVER",
            "state": "CA",
            "postal_code": "956704457",
            "telephone_number": "916-709-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11344 COLOMA RD",
            "address_2": "SUITE 435",
            "city": "GOLD RIVER",
            "state": "CA",
            "postal_code": "956704457",
            "telephone_number": "916-709-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTHENTIC COUNSELING ASSOCIATES - A PSYCHOLOGICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-07",
        "last_updated": "2012-09-07",
        "status": "A",
        "authorized_official_last_name": "MATHE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "LEWIS",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "916-709-1170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gold River, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.