Individual provider Active NPI

Paula Mathiasen

  • Mental Health Counselor
  • Arlington Heights, IL
National Provider Identifier
1336470822
Registry record updated May 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180.007404 Issued in IL
Practice address
120 W Eastman St
Suite 305
Arlington Heights, IL 60004-5937
Phone
(847) 255-7704
NPI assigned
Jan 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180.007404 IL Primary

Addresses

Primary practice location

120 W Eastman St
Suite 305
Arlington Heights, IL 60004-5937

Mailing address

120 W Eastman St
Suite 305
Arlington Heights, IL 60004-5937
Phone (847) 255-7704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20241017002925 IL Practitioner - Mental Health Counselor 1658803432 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180.007404ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Sep 11, 2024 Accepting new patients
Life Counseling Center Inc Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

605 N Michigan Ave
Fl 4
Chicago, IL 60611
Phone (773) 232-5338

Organizations & group practices 2

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": "1264118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369958400000",
    "number": "1336470822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W EASTMAN ST",
            "address_2": "SUITE 305",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600045937",
            "telephone_number": "847-255-7704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W EASTMAN ST",
            "address_2": "SUITE 305",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600045937",
            "telephone_number": "847-255-7704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIASEN",
        "first_name": "PAULA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-22",
        "last_updated": "2013-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.007404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.