Active NPI
Gregory Mathis, LPC
- Mental Health Counselor
- Washington, DC
National Provider Identifier
1215317680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- PRC195
- Practice address
- 4017 Minnesota Ave NE
Washington, DC 20019-3541 - Phone
- (202) 388-9202
- Fax
- (202) 388-9209
- NPI assigned
- Jun 1, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | PRC195 | DC | Primary |
Addresses
Primary practice location
4017 Minnesota Ave NE
Washington, DC 20019-3541
Mailing address
2822 28TH St SE
Washington, DC 20020-2618
Phone (301) 919-6348
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 |
|---|---|---|---|
| PRC195 | DC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433116800000",
"number": "1215317680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2822 28TH ST SE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200202618",
"telephone_number": "301-919-6348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4017 MINNESOTA AVE NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200193541",
"telephone_number": "202-388-9202",
"fax_number": "202-388-9209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHIS",
"first_name": "GREGORY",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-01",
"last_updated": "2015-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "DC",
"license": "PRC195",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.