Individual provider Active NPI

Marianela Matheus, LPC,CPCS,RPT

  • Mental Health Counselor
  • Dunwoody, GA
National Provider Identifier
1114136603
Registry record updated Oct 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
002525 Issued in GA
Practice address
2050 Beaumont LN
Dunwoody, GA 30338-4500
Phone
(770) 351-9033
Fax
(770) 772-0355
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 002525 GA Primary

Addresses

Primary practice location

2050 Beaumont LN
Dunwoody, GA 30338-4500

Mailing address

2050 Beaumont LN
Dunwoody, GA 30338-4500
Phone (770) 351-9033

Other practice location 1

2750 Old Alabama Rd
Suite 200
Alpharetta, GA 30022-8593
Phone (678) 336-3260

Other identifiers 1

IdentifierTypeStateIssuer
003200881AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20260511000733 GA Practitioner - Mental Health Counselor 2466920236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1984
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2050 Beaumont LN
Atlanta, GA 30338-4500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002525GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marin Matheus and Associates, LLC Current 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.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1114136603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 BEAUMONT LN",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303384500",
            "telephone_number": "770-351-9033",
            "fax_number": "770-772-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 BEAUMONT LN",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303384500",
            "telephone_number": "770-351-9033",
            "fax_number": "770-772-0355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2750 Old Alabama Rd",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300228593",
            "country_code": "US",
            "telephone_number": "678-336-3260",
            "fax_number": "770-772-0355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHEUS",
        "first_name": "MARIANELA",
        "name_prefix": "Mrs.",
        "credential": "LPC,CPCS,RPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "002525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003200881A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunwoody, GA

Sources for this page

Verify at the official NPI Registry.