Active NPI
Erica Mathis, PH.D.
- Counseling Psychologist
- Austin, TX
National Provider Identifier
1790375350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- Practice address
- 5900 Balcones Dr # 12022
Austin, TX 78731-4257 - Phone
- (512) 706-9380
- NPI assigned
- Jan 19, 2021
- Last updated
- Oct 30, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Clinical Psychologist | 103TC0700X | 38442 | TX | |
| Counseling Psychologist | 103TC1900X | Primary | ||
| Health Service Psychologist | 103TH0100X |
Addresses
Primary practice location
5900 Balcones Dr # 12022
Austin, TX 78731-4257
Mailing address
PO Box 911
Buda, TX 78610-0911
Phone (512) 706-9380
Other practice location 1
174 Moon Stone Trl
Buda, TX 78610-2097
Phone (512) 706-9380
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38442 | TX | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deep Eddy Advanced Care LLC | Psychologist | Past | Accepting new patients |
| Deep Centered Psychiatry PLLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychiatry Physician
- Austin, TX
- NPI 1629853825
-
- Psychologist
- Austin, TX
- NPI 1174225247
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698624000000",
"number": "1790375350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 911",
"city": "BUDA",
"state": "TX",
"postal_code": "786100911",
"telephone_number": "512-706-9380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 BALCONES DR # 12022",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787314257",
"telephone_number": "512-706-9380"
}
],
"practiceLocations": [
{
"address_1": "174 Moon Stone Trl",
"address_purpose": "LOCATION",
"city": "Buda",
"state": "TX",
"postal_code": "786102097",
"country_code": "US",
"telephone_number": "512-706-9380",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MATHIS",
"first_name": "ERICA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-19",
"last_updated": "2023-10-30",
"certification_date": "2023-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "38442",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": null,
"license": null,
"primary": true
},
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.