Active NPI
Matthew D. Weatherly, PLPC
- Professional Counselor
- Springfield, MO
National Provider Identifier
1780907337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2010005419
- Practice address
- 440 S Market Ave
Springfield, MO 65806-2026 - Phone
- (417) 865-5581
- NPI assigned
- Mar 10, 2010
- Sex
- Male
- 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 | 2010005419 | MO | Primary |
Addresses
Primary practice location
440 S Market Ave
Springfield, MO 65806-2026
Mailing address
2625 E Stanford St
Springfield, MO 65804-2040
Phone (417) 770-4404
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 |
|---|---|---|---|
| 2010005419 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286236800000",
"number": "1780907337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2625 E STANFORD ST",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658042040",
"telephone_number": "417-770-4404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "440 S MARKET AVE",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658062026",
"telephone_number": "417-865-5581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEATHERLY",
"first_name": "MATTHEW",
"middle_name": "D.",
"name_prefix": "Mr.",
"credential": "PLPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-03-10",
"last_updated": "2010-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2010005419",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.