Gregory John Matysik, LPC, CSAC, PHD

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

15307 132 Issued in WI

Practice address

300 Femrite Dr
Monona, WI 53716-3716

Phone

(608) 222-7311

Fax

(608) 222-0453

NPI assigned

Mar 15, 2010

Last updated

Mar 15, 2010By the provider in NPPES

Sex

Male

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

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Psychology Clinic Inc.

  • Clinic/Center
  • Madison, WI
  • NPI 1336222769
  NPD (past)

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

{
    "created_epoch": "1268611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268611200000",
    "number": "1407170814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 FEMRITE DR",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537163716",
            "telephone_number": "608-222-7311",
            "fax_number": "608-222-0453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FEMRITE DR",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537163716",
            "telephone_number": "608-222-7311",
            "fax_number": "608-222-0453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATYSIK",
        "first_name": "GREGORY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "LPC, CSAC, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-15",
        "last_updated": "2010-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "WI",
            "license": "3847 125",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "WI",
            "license": "15307 132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Sue Marks, LMFT
• Uschi Marschke
• Katharine Marshall, M.A., L.C.P.C.,C.R.C
• Sara Marshall, APNP
• Boris Matthews, PH.D.
• William R. McAuliffe-Schroeder, LCSW, SAC
• Jane McCauley I, LCSW
• Brett McClone
• Constance McConnell, LCSW
• Michael Healy McDonald, M.D.

• Substance Abuse Rehabilitation Facility in Monona, WI
• Providers in Monona, WI by specialty
• Substance Abuse Rehabilitation Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2010; 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.