Active NPI
Tina Brien Matthews, CADAC
- Addiction (Substance Use Disorder) Counselor
- Worcester, MA
National Provider Identifier
1023124641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1209AD
- Practice address
- 585 Lincoln Street
Worcester, MA 01605 - Phone
- (508) 854-3320
- Fax
- (508) 753-5051
- NPI assigned
- Aug 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1209AD | MA | Primary |
Addresses
Primary practice location
585 Lincoln Street
Worcester, MA 01605
Mailing address
585 Lincoln Street
Worcester, MA 01605
Phone (508) 854-3320
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306421 | Medicaid | MA | |
| 2220002001 | Other | MA | BCBS SA |
| 1308785 | Other | MA | MCD MH |
| M18685 | Other | BCBS MH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1209AD | MA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023124641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "585 LINCOLN STREET",
"city": "WORCESTER",
"state": "MA",
"postal_code": "01605",
"telephone_number": "508-854-3320",
"fax_number": "508-753-5051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "585 LINCOLN STREET",
"city": "WORCESTER",
"state": "MA",
"postal_code": "01605",
"telephone_number": "508-854-3320",
"fax_number": "508-753-5051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRIEN MATTHEWS",
"first_name": "TINA",
"name_prefix": "Mrs.",
"credential": "CADAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MA",
"license": "1209AD",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1306421",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS SA",
"identifier": "2220002001",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCD MH",
"identifier": "1308785",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MH",
"identifier": "M18685",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.