Kathleen Walsh Matay, MA, LPC, CCTP

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701013405 Issued in VA

Practice address

1360 Beverly Rd Ste 200
MC Lean, VA 22101-3647

Phone

(703) 831-8300

NPI assigned

Oct 4, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Commonwealth Counseling Associates IncGroup PAC ID 0941288583, 207 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: granatogroup.kathymatay@144557.advancedmd-direct.com

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.

• Commonwealth Counseling Associates Inc

  • Clinical Psychologist
  • Mechanicsville, VA
  • NPI 1851345805

  DC, Professional

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1601769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1043817943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 SENECA RD",
            "city": "GREAT FALLS",
            "state": "VA",
            "postal_code": "220661111",
            "telephone_number": "703-298-8958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 BEVERLY RD STE 200",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013647",
            "telephone_number": "703-831-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATAY",
        "first_name": "KATHLEEN",
        "middle_name": "WALSH",
        "credential": "MA, LPC, CCTP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-04",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701013405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annie Martirossian
• Robert Babak Marzban, DDS MDS
• Suzanne Duvalsaint Marzban, DDS, MS
• Tareq Massimi, M.D.
• Jordan Taylor Masters, MSW, LGSW
• Cynthia Renee Mathis, LMFT
• Venkata Satyanand Mattay, M.D.
• Lani Matthews, MD
• Meghan Matthews, DPT
• Melissa A Matthews, MD

• Professional Counselor in MC Lean, VA
• Providers in MC Lean, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.