Amanda Jean Matthews, LCSW-1354

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

L12964 Issued in OR

Practice address

11590 SW Lomita Ave
Tigard, OR 97223-6419

Phone

(307) 349-8491

NPI assigned

Dec 1, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1512086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1386158111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8915 SW CENTER ST",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236307",
            "telephone_number": "503-726-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11590 SW LOMITA AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236419",
            "telephone_number": "307-349-8491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "AMANDA",
        "middle_name": "JEAN",
        "credential": "LCSW-1354",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-01",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WY",
            "license": "LCSW-1354",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "L12964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Matheson
• Devon A Mathews, CADCII
• Carole L Matiaco, RD, LD
• Hiroshi Matsushita
• Amanda Ann Matthews
• Erica Dawn Mattson
• Misty Laura Matusch
• Mystery Anastasia Matusch I
• Benjamin D Maurer
• Benjamin Mauro

• Mental Health Counselor in Tigard, OR
• Providers in Tigard, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.