Active NPI
Gloria Constance Mathiesen, LPC
- Professional Counselor
- Tucson, AZ
National Provider Identifier
1811766553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-19598
- Practice address
- 2002 E River Rd Apt K12
Tucson, AZ 85718-6551 - Phone
- (520) 425-6572
- NPI assigned
- Dec 21, 2023
- Last updated
- Dec 21, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-19598 | AZ | Primary |
Addresses
Primary practice location
2002 E River Rd Apt K12
Tucson, AZ 85718-6551
Mailing address
2002 E River Rd Apt K12
Tucson, AZ 85718-6551
Phone (520) 425-6572
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 |
|---|---|---|---|
| LPC-19598 | AZ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1703116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703116800000",
"number": "1811766553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2002 E RIVER RD APT K12",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857186551",
"telephone_number": "520-425-6572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2002 E RIVER RD APT K12",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857186551",
"telephone_number": "520-425-6572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHIESEN",
"first_name": "GLORIA",
"middle_name": "CONSTANCE",
"name_prefix": "Ms.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-12-21",
"last_updated": "2023-12-21",
"certification_date": "2023-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC-19598",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.