Active NPI
Patty K Matheny, LCSW
- Clinical Social Worker
- Paradise, CA
National Provider Identifier
1063633857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS 6906
- Practice address
- 5730 Canyon View Dr
Paradise, CA 95969-5534 - Phone
- (530) 876-3174
- Fax
- (530) 876-2183
- NPI assigned
- May 1, 2007
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS 6906 | CA | Primary |
Addresses
Primary practice location
5730 Canyon View Dr
Paradise, CA 95969-5534
Mailing address
5730 Canyon View Dr
Paradise, CA 95969-5534
Phone (530) 876-3174
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LCS 6906 | Other | CA | LCSW |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6906 | CA | MD | Professional Counselor |
| LCS 6906 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063633857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5730 CANYON VIEW DR",
"city": "PARADISE",
"state": "CA",
"postal_code": "959695534",
"telephone_number": "530-876-3174",
"fax_number": "530-876-2183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5730 CANYON VIEW DR",
"city": "PARADISE",
"state": "CA",
"postal_code": "959695534",
"telephone_number": "530-876-3174",
"fax_number": "530-876-2183"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHENY",
"first_name": "PATTY",
"middle_name": "K",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS 6906",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW",
"identifier": "LCS 6906",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Paradise, CA
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.