Consuelo Maturana, LPC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

2000143549 Issued in MO

Practice address

7505 Pershing Ave Apt 2W
Saint Louis, MO 63130-4024

Phone

(314) 223-5754

NPI assigned

Aug 17, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Mental Health Counselor

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Provident IncGroup PAC ID 0345217279, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Provident Inc.

  dba Provident Behavioral Health

  • Mental Health Counselor
  • Saint Louis, MO
  • NPI 1710023791
  Medicare reassignment Care Compare group NPD
• Provident Inc

  dba Provident Behavioral Health

  • Mental Health Counselor
  • Saint Louis, MO
  • NPI 1043491020
  NPD (past)

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1518483825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7505 PERSHING AVE APT 2W",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631304024",
            "telephone_number": "314-223-5754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7505 PERSHING AVE APT 2W",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631304024",
            "telephone_number": "314-223-5754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATURANA",
        "first_name": "CONSUELO",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MO",
            "license": "2000143549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maureen Ann Mattingly, M.S., CCC-SLP
• Tori Marie Mattingly, FNP
• Mattis Road Counseling, LLC
• Mattis Road Surgery Center LLC
• Ross Mattox, D.C.
• George M. Matuschak, M.D.
• Rachel Ann Matusiak, M.S., R.D., L.D.
• Sydney Lauren Matusik, PA
• Margaret Mary Matusofsky, M.S.
• Amanda Lynne Matysik, ACNP

• Counseling Psychologist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Counseling Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.