Individual provider Active NPI

Matthew Adam Donahue, LGPC

  • Mental Health Counselor
  • Westminster, MD
National Provider Identifier
1710595038
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC12573 Issued in MD
Practice address
10 Distillery Rd Ste 200
Westminster, MD 21157-5344
Phone
(410) 871-1478
NPI assigned
Jul 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LGP10533 MD
Mental Health Counselor 101YM0800X LC12573 MD Primary

Addresses

Primary practice location

10 Distillery Rd Ste 200
Westminster, MD 21157-5344

Mailing address

1003 W 7TH St Ste 403
Frederick, MD 21701-8532
Phone (240) 575-9688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20240809001579 MD Practitioner - Mental Health Counselor 8820536717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dagenhart Health and Wellness, LLCGroup PAC ID 2365817582, 6 clinicians

Practice addresses (Care Compare)

5301 Buckeystown Pike
Suite 170
Frederick, MD 21704-8380
Phone (240) 575-9688

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LGP10533MDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dagenhart Health and Wellness, LLC CurrentSince May 9, 2024 Accepting new patients

Locations

1003 W 7th St
Ste 403
Frederick, MD 21701
Phone (240) 575-9688

5301 Buckeystown Pike
Ste 170
Frederick, MD 21704
Phone (240) 575-9688

Organizations & group practices 1

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": "1595376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1710595038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 W 7TH ST STE 403",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217018532",
            "telephone_number": "240-575-9688",
            "fax_number": "301-732-6916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 DISTILLERY RD STE 200",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575344",
            "telephone_number": "410-871-1478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONAHUE",
        "first_name": "MATTHEW",
        "middle_name": "ADAM",
        "credential": "LGPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-22",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LGP10533",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC12573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, MD

Sources for this page

Verify at the official NPI Registry.