Individual provider Active NPI

Sandra Jo Mathis

  • Counselor
  • Yankton, SD
National Provider Identifier
1053183418
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
610 W 23Rd St Ste 5
Yankton, SD 57078-1209
Phone
(605) 204-6646
NPI assigned
Oct 27, 2023
Last updated
Nov 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

610 W 23Rd St Ste 5
Yankton, SD 57078-1209

Mailing address

610 W 23Rd St Ste 5
Yankton, SD 57078-1209
Phone (605) 204-6646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240624004480 SD Practitioner - Mental Health Counselor 5597208181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rising Hope Counseling, LLCGroup PAC ID 3274958640, 47 clinicians

Practice addresses (Care Compare)

610 W 23Rd St
Suite 7
Yankton, SD 57078-1218
Phone (605) 494-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rising Hope Counseling, LLC CurrentSince May 7, 2024 Accepting new patients
Rising Hope Together, Inc PastSince Jan 24, 2021 Accepting new patients

Locations

317 N Heritage Ave
Tea, SD 57064

610 W 23rd St
Ste 5
Yankton, SD 57078
Phone (605) 204-6646

610 W 23rd St
Ste 7
Yankton, SD 57078

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1698364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1053183418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 W 23RD ST STE 5",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570781209",
            "telephone_number": "605-204-6646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 W 23RD ST STE 5",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570781209",
            "telephone_number": "605-204-6646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "SANDRA",
        "middle_name": "JO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-27",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yankton, SD

Sources for this page

Verify at the official NPI Registry.