Active NPI
Ramona Hernandez Mathis, LCSW
- Clinical Social Worker
- South Bend, IN
National Provider Identifier
1215195128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34002783A
- Practice address
- 53322 Catalina CT
South Bend, IN 46635-1342 - Phone
- (574) 273-1598
- Fax
- (574) 968-0615
- NPI assigned
- May 28, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34002783A | IN | Primary |
| Marriage & Family Therapist | 106H00000X | 35000537A | IN |
Addresses
Primary practice location
53322 Catalina CT
South Bend, IN 46635-1342
Mailing address
53322 Catalina CT
South Bend, IN 46635-1342
Phone (574) 273-1598
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2268 | Other | NATIONAL BOARD OF CERTIFIED CLINICAL HYPNOTHERAPISTS, FELLOW STATUS |
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 |
|---|---|---|---|
| 34002783A | IN | MD | Clinical Social Worker |
| 35000537A | IN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211932800000",
"number": "1215195128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "53322 CATALINA CT",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466351342",
"telephone_number": "574-273-1598",
"fax_number": "574-968-0615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "53322 CATALINA CT",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466351342",
"telephone_number": "574-273-1598",
"fax_number": "574-968-0615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHIS",
"first_name": "RAMONA",
"middle_name": "HERNANDEZ",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-28",
"last_updated": "2008-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34002783A",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IN",
"license": "35000537A",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL BOARD OF CERTIFIED CLINICAL HYPNOTHERAPISTS, FELLOW STATUS",
"identifier": "2268",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.