Active NPI
Laura L Mathews, PHD
- Clinical Child & Adolescent Psychologist
- Milwaukee, WI
National Provider Identifier
1043254428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 3235
- Practice address
- 9000 W Wisconsin Ave
Child and Adolescent Psychology
Milwaukee, WI 53226-4874 - Phone
- (414) 266-2932
- Fax
- (414) 266-3735
- NPI assigned
- Jun 15, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 20041985 | IN | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 3235 | WI | Primary |
Addresses
Primary practice location
9000 W Wisconsin Ave
Child and Adolescent Psychology
Milwaukee, WI 53226-4874
Mailing address
9000 W Wisconsin Ave
Child and Adolescent Psychology
Milwaukee, WI 53226-4874
Phone (414) 266-2932
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200804750 | Medicaid | IN |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3235 | WI | MD | Clinical Child & Adolescent Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indiana University Health, Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434412800000",
"number": "1043254428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9000 W WISCONSIN AVE",
"address_2": "CHILD AND ADOLESCENT PSYCHOLOGY",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532264874",
"telephone_number": "414-266-2932",
"fax_number": "414-266-3735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9000 W WISCONSIN AVE",
"address_2": "CHILD AND ADOLESCENT PSYCHOLOGY",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532264874",
"telephone_number": "414-266-2932",
"fax_number": "414-266-3735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHEWS",
"first_name": "LAURA",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-15",
"last_updated": "2015-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "IN",
"license": "20041985",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "WI",
"license": "3235",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200804750",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.