Active NPI
Lauren Matesich
- Professional Counselor
- Philadelphia, PA
National Provider Identifier
1740945773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC013857
- Practice address
- 1015 Chestnut St Ste 1520
Philadelphia, PA 19107-4315 - Phone
- (855) 284-7483
- NPI assigned
- Nov 4, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC013857 | PA | Primary |
Addresses
Primary practice location
1015 Chestnut St Ste 1520
Philadelphia, PA 19107-4315
Mailing address
1000 Jefferson St Ste 2C
Lynchburg, VA 24504-1724
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 |
|---|---|---|---|
| PC013857 | PA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635984000000",
"number": "1740945773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 JEFFERSON ST STE 2C",
"city": "LYNCHBURG",
"state": "VA",
"postal_code": "245041724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 CHESTNUT ST STE 1520",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191074315",
"telephone_number": "855-284-7483"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATESICH",
"first_name": "LAUREN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-04",
"last_updated": "2021-11-04",
"certification_date": "2021-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC013857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.