Individual provider Active NPI

Shannon Matthews, PHD , LPCS

  • Professional Counselor
  • Lufkin, TX
National Provider Identifier
1346007853
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
63704 Issued in TX
Practice address
106 Normandy Dr
Lufkin, TX 75901-6367
Phone
(936) 676-0904
NPI assigned
Mar 1, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Professional Counselor 101YP2500X 63704 TX Primary

Addresses

Primary practice location

106 Normandy Dr
Lufkin, TX 75901-6367

Mailing address

106 Normandy Dr
Lufkin, TX 75901-6367
Phone (936) 676-0904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20241022002640 TX Practitioner - Mental Health Counselor 9133651680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathways Forensic and Mental Health Services, PLLCGroup PAC ID 1557719960, 3 clinicians

Practice addresses (Care Compare)

103 Wildlife LN
Lufkin, TX 75904-1615
Phone (936) 238-3868

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Forensic & Mental Health Services, PLLC CurrentSince Jul 20, 2024 Accepting new patients

Locations

103 Wildlife Ln
Lufkin, TX 75904
Phone (936) 238-3868

Organizations & group practices 1

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": "1709251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1346007853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 NORMANDY DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759016367",
            "telephone_number": "936-676-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 NORMANDY DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759016367",
            "telephone_number": "936-676-0904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "SHANNON",
        "credential": "PHD , LPCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-01",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "63704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lufkin, TX

Sources for this page

Verify at the official NPI Registry.