Donald O'Dell Matthews, L.P.C.
Individual provider Active NPI Professional Counselor · Juneau, WI
NPI 1720179013 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720179013
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 3246-125 (WI)
- Practice address
- 199 Home Rd
Juneau, WI 53039-1401 - Phone
- (920) 386-3500
- Fax
- (920) 386-3812
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- County of Dodge
Practice addresses (Care Compare)
199 County Rd DF
Suite 3
Juneau, WI 53039-9512
Phone (920) 386-4094
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240103000104 | WI | Practitioner - Mental Health Counselor | 2062862071 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3246-125 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Dodge | Current |
Accepting new patients | |
| County of Dodge | Current |
Accepting new patients |
Locations
199 County Road DF
Fl 3
Juneau, WI 53039
Phone (920) 386-4094
199 County Road DF
#3
Juneau, WI 53039
Phone (920) 386-4094
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3246-125 | WI | Yes |
Addresses
Primary practice location
199 Home Rd
Juneau, WI 53039-1401
Mailing address
199 Home Rd
Juneau, WI 53039-1401
Phone (920) 386-3500
Other providers in Juneau, WI
- Chloe Ruth Lehman
- Erin Elizabeth Lueck
- Marsh Country Health Alliance
- Marsh Country Health Alliance
- Marsh Country Health Alliance
- Wendy Marie McGurk
- Vonne Mary Meussling-Barnett
- Aaron Miller
- Mind Body Program LLC
- Aubrie Morrell
All providers in Juneau, WI · Professional Counselor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.