Individual provider Active NPI

Fred Ray Dumez-Matheson, LMHC

  • Mental Health Counselor
  • Seattle, WA
National Provider Identifier
1457625949
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60525325 Issued in WA
Practice address
1914 N 34TH St Ste 504
Seattle, WA 98103-9007
Phone
(206) 569-4937
NPI assigned
Feb 29, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH60525325 WA Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

1914 N 34TH St Ste 504
Seattle, WA 98103-9007

Mailing address

19504 8TH Ave NW
Shoreline, WA 98177-2554
Phone (206) 569-4937

Other names 1

  • Mr. Fred Ray Matheson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Mar 12, 2024 through Mar 12, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LH60525325WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1330473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1457625949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19504 8TH AVE NW",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981772554",
            "telephone_number": "206-569-4937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1914 N 34TH ST STE 504",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981039007",
            "telephone_number": "206-569-4937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMEZ-MATHESON",
        "first_name": "FRED",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-29",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60525325",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FRED",
            "last_name": "MATHESON",
            "middle_name": "RAY",
            "prefix": "MR.",
            "credential": "LMHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.