Active NPI
Meghan Mattos, PSYD
- Clinical Psychologist
- North Charleston, SC
National Provider Identifier
1740689611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810004993
- Practice address
- 9225 University Blvd
Suite E2-a
North Charleston, SC 29406-9149 - Phone
- (843) 637-4211
- NPI assigned
- Aug 17, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810004993 | VA | Primary |
| Clinical Psychologist | 103TC0700X | 1347 | SC |
Addresses
Primary practice location
9225 University Blvd
Suite E2-a
North Charleston, SC 29406-9149
Mailing address
9225 University Blvd
Suite E2-a
North Charleston, SC 29406-9149
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0810004993 | VA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426636800000",
"number": "1740689611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9225 UNIVERSITY BLVD",
"address_2": "SUITE E2-A",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294069149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9225 UNIVERSITY BLVD",
"address_2": "SUITE E2-A",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294069149",
"telephone_number": "843-637-4211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTOS",
"first_name": "MEGHAN",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-17",
"last_updated": "2015-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810004993",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "SC",
"license": "1347",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.