Vanessa Matossian, M.S., L.P.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-6260 Issued in ID

Practice address

317 W 6TH St Ste 208
Moscow, ID 83843-2387

Phone

(208) 882-3504

Fax

(208) 882-3572

NPI assigned

Jul 18, 2016

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

Medicare fee-for-service enrollment

Enrolled in ID

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Scott Community Care, PLLCGroup PAC ID 2567701618, 7 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.

• Scott Community Care, PLLC

  • Professional Counselor
  • Moscow, ID
  • NPI 1356644769
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468800000000",
    "number": "1669825451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 N GARFIELD ST",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838433666",
            "telephone_number": "208-596-9971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 W 6TH ST STE 208",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838432387",
            "telephone_number": "208-882-3504",
            "fax_number": "208-882-3572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOSSIAN",
        "first_name": "VANESSA",
        "credential": "M.S., L.P.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-18",
        "last_updated": "2016-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LPC-6260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christian Edith Martinez
• Nickolai Martonick
• Kurt R Martyn, MD
• Roxanne Maslikowski
• Andrea L Masom, LCPC
• James Michael May, ATC
• Timothy Matthew Neil McCabe, MD
• James David McCall
• Liberty Nicole McCarley, BS
• Matthew McElroy

• Professional Counselor in Moscow, ID
• Providers in Moscow, ID by specialty
• Professional Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2016; 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.