Individual provider Active NPI

Matthew Lenertz, M.C., LISAC, LPC

  • Professional Counselor
  • Tucson, AZ
National Provider Identifier
1215305883
Registry record updated Sep 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-13784 Issued in AZ
Practice address
1773 W Saint Marys Rd Ste 202
Tucson, AZ 85745-2654
Phone
(928) 376-0026
Fax
(928) 782-2298
NPI assigned
Sep 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPC-13784 AZ
Addiction (Substance Use Disorder) Counselor 101YA0400X LISAC-11880 AZ
Mental Health Counselor 101YM0800X LPC-13784 AZ
Professional Counselor 101YP2500X LPC-13784 AZ Primary

Addresses

Primary practice location

1773 W Saint Marys Rd Ste 202
Tucson, AZ 85745-2654

Mailing address

1773 W Saint Marys Rd Ste 202
Tucson, AZ 85745-2654
Phone (520) 668-4132

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

LicenseStateTypeSpecialty
LISAC-11880AZMDAddiction (Substance Use Disorder) Counselor
LPC-13784AZMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Buena Vista Recovery, LLC PastSince Nov 8, 2020 Accepting new patients
Buena Vista Recovery, LLC PastSince Jul 16, 2023 Accepting new patients
Buena Vista Recovery PastSince May 1, 2020 Accepting new patients
Buena Vista Recovery, LLC PastSince May 31, 2020 Accepting new patients

Organizations & group practices 4

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": "1442016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442016000000",
    "number": "1215305883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1773 W SAINT MARYS RD STE 202",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452654",
            "telephone_number": "520-668-4132",
            "fax_number": "928-782-2298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1773 W SAINT MARYS RD STE 202",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452654",
            "telephone_number": "928-376-0026",
            "fax_number": "928-782-2298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENERTZ",
        "first_name": "MATTHEW",
        "credential": "M.C., LISAC, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-12",
        "last_updated": "2015-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AZ",
            "license": "LPC-13784",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC-11880",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC-13784",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-13784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.