Active NPI
Matthew Mortensen
- Counselor
- Chardon, OH
National Provider Identifier
1568376754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- S-2614681
- Practice address
- 602 South St
Chardon, OH 44024-1499 - Phone
- (440) 251-2406
- NPI assigned
- Oct 2, 2026
- Last updated
- Oct 2, 2026
- Sex
- Unspecified or another gender identity
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | S-2614681 | OH | Primary |
Addresses
Primary practice location
602 South St
Chardon, OH 44024-1499
Mailing address
7106 Barton Dr
Mentor, OH 44060-4409
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790899200000",
"number": "1568376754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7106 BARTON DR",
"city": "MENTOR",
"state": "OH",
"postal_code": "440604409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "602 SOUTH ST",
"city": "CHARDON",
"state": "OH",
"postal_code": "440241499",
"telephone_number": "440-251-2406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORTENSEN",
"first_name": "MATTHEW",
"sole_proprietor": "YES",
"sex": "X",
"enumeration_date": "2026-10-02",
"last_updated": "2026-10-02",
"certification_date": "2026-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OH",
"license": "S-2614681",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chardon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.