Individual provider Active NPI

Cynthia T. Matthew, PH.D.

  • Professional Counselor
  • Old Saybrook, CT
National Provider Identifier
1497852644
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
000175 Issued in CT
Practice address
841 Middlesex Tpke
Old Saybrook, CT 06475-1317
Phone
(860) 395-0111
Fax
(860) 395-1264
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 000175 CT Primary

Addresses

Primary practice location

841 Middlesex Tpke
Old Saybrook, CT 06475-1317

Mailing address

841 Middlesex Tpke
Old Saybrook, CT 06475-1317
Phone (860) 395-0111

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
000175CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Karl E Scheibe Past Accepting new patients
Saybrook Center LLC Past Accepting new patients

Organizations & group practices 2

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497852644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 MIDDLESEX TPKE",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064751317",
            "telephone_number": "860-395-0111",
            "fax_number": "860-395-1264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 MIDDLESEX TPKE",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064751317",
            "telephone_number": "860-395-0111",
            "fax_number": "860-395-1264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEW",
        "first_name": "CYNTHIA",
        "middle_name": "T.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "000175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Saybrook, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.