Active NPI
Mary Kaye Nicole Matthews, PSY.D.
- Clinical Psychologist
- Louisville, KY
National Provider Identifier
1184965469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 38742
- Practice address
- 800 Zorn Ave
Louisville, KY 40206-1433 - Phone
- (502) 287-4000
- NPI assigned
- Mar 11, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810004401 | VA | |
| Clinical Psychologist | 103TC0700X | 38742 | TX | Primary |
Addresses
Primary practice location
800 Zorn Ave
Louisville, KY 40206-1433
Mailing address
7521 Sidbury Cir
San Antonio, TX 78250-5254
Other practice location 1
7400 Merton Minter St
San Antonio, TX 78229-4404
Phone (210) 617-5300
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38742 | TX | MD | Clinical Psychologist |
| 0810004401 | VA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cognitive Serenity Holistic Mental Health Care, PLLC | Clinical | Current | Accepting new patients |
Locations
8407 Bandera Rd
Ste 103
San Antonio, TX 78250
Phone (210) 549-8071
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.
-
- Clinical Psychologist
- San Antonio, TX
- NPI 1881313997
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659571200000",
"number": "1184965469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7521 SIDBURY CIR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782505254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 ZORN AVE",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402061433",
"telephone_number": "502-287-4000"
}
],
"practiceLocations": [
{
"address_1": "7400 Merton Minter St",
"address_purpose": "LOCATION",
"city": "San Antonio",
"state": "TX",
"postal_code": "782294404",
"country_code": "US",
"telephone_number": "210-617-5300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MATTHEWS",
"first_name": "MARY KAYE",
"middle_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-11",
"last_updated": "2022-08-04",
"certification_date": "2022-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810004401",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "38742",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.