Individual provider Active NPI

Matthew Aaron Dashner, MHR, LPC

  • Mental Health Counselor
  • Stillwater, OK
National Provider Identifier
1295143063
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6056 Issued in OK
Practice address
604 S Walnut St
Stillwater, OK 74074-4222
Phone
(405) 372-2202
Fax
(405) 445-3780
NPI assigned
Jul 24, 2014
Last updated
Jul 29, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X 6056 OK Primary

Addresses

Primary practice location

604 S Walnut St
Stillwater, OK 74074-4222

Mailing address

604 S Walnut St
Stillwater, OK 74074-4222
Phone (405) 372-2202

Other practice location 1

4436 N.W. 50th
Oklahoma City, OK 73112
Phone (405) 858-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20240821003278 OK Practitioner - Mental Health Counselor 9234677295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

111 S Treaty Rd
Miami, OK 74354-5327
Phone (918) 540-1511

998 E Knotts Ave
Stillwater, OK 74075-3023
Phone (405) 372-2202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6056OKMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Lake Mental Health Center, Inc. CurrentSince Jul 10, 2024 Accepting new patients
Grand Lake Mental Health Center, Inc. Current Accepting new patients
Grand Lake Mental Health Center Inc. CurrentSince Jul 10, 2024 Accepting new patients

Locations

111 S Treaty Rd
Miami, OK 74354
Phone (918) 540-1511

114 W Delaware Ave
Nowata, OK 74048
Phone 91827318412207

604 S Walnut St
Stillwater, OK 74074
Phone (405) 338-7072

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1406160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1295143063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 S WALNUT ST",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744222",
            "telephone_number": "405-372-2202",
            "fax_number": "405-445-3780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 S WALNUT ST",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744222",
            "telephone_number": "405-372-2202",
            "fax_number": "405-445-3780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4436 N.W. 50th",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "73112",
            "country_code": "US",
            "telephone_number": "405-858-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DASHNER",
        "first_name": "MATTHEW",
        "middle_name": "AARON",
        "name_prefix": "Mr.",
        "credential": "MHR, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-24",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "6056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, OK

Sources for this page

Verify at the official NPI Registry.