Roberta Lee Mathern, MS, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1331 Issued in MN

Practice address

610 Florence Ave
Owatonna, MN 55060-4704

Phone

(507) 451-2630

Fax

(507) 455-8133

NPI assigned

Oct 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Bobbi Lee Mathern Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Marriage and Family Therapist

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Secure Base Counseling Center LLCGroup PAC ID 8628409299, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Secure Base Counseling Center LLC

  • Psychologist
  • Northfield, MN
  • NPI 1285905885

  Marriage & Family Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1487743977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 FLORENCE AVE",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550604704",
            "telephone_number": "507-451-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 FLORENCE AVE",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550604704",
            "telephone_number": "507-451-2630",
            "fax_number": "507-455-8133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHERN",
        "first_name": "ROBERTA",
        "middle_name": "LEE",
        "credential": "MS, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "57443SK",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "485048300",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "messagec@direct.schrc.com",
            "affiliation": "N",
            "address_1": "610 Florence Ave",
            "city": "Owatonna",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550604704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BOBBI",
            "last_name": "MATHERN",
            "middle_name": "LEE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• George Marcus, M.D.
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• Christina Marsolek
• Martin Supportive Services
• Emma Marie Massman, LICSW
• Mayo Clinic Health System-Southeast Minnesota Region
• Mayo Clinic Hospital-Rochester
• Mayo Foundation for Medical Education & Research
• Julia McCabe, MS, CCC-SLP
• McGregor Chiropractic PC

• Marriage & Family Therapist in Owatonna, MN
• Providers in Owatonna, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.