Active NPI
Mattie Costill, LPCMH
- Professional Counselor
- Lewes, DE
National Provider Identifier
1346690112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC-0000714
- Practice address
- 17021 Old Orchard Rd
Lewes, DE 19958-4832 - Phone
- (302) 703-6332
- NPI assigned
- Jun 13, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC-0000714 | DE | Primary |
Addresses
Primary practice location
17021 Old Orchard Rd
Lewes, DE 19958-4832
Mailing address
782 Hill Ave
Aston, PA 19014-1110
Phone (610) 675-6380
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 |
|---|---|---|---|
| PC-0000714 | DE | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mattie Costill LLC | Professional | Current | Accepting new patients |
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": "1465776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465776000000",
"number": "1346690112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "782 HILL AVE",
"city": "ASTON",
"state": "PA",
"postal_code": "190141110",
"telephone_number": "610-675-6380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17021 OLD ORCHARD RD",
"city": "LEWES",
"state": "DE",
"postal_code": "199584832",
"telephone_number": "302-703-6332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTILL",
"first_name": "MATTIE",
"credential": "LPCMH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-13",
"last_updated": "2016-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "DE",
"license": "PC-0000714",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewes, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.