Active NPI
Rebecca Mattern, LPC
- Professional Counselor
- Addison, TX
National Provider Identifier
1902030364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 61269
- Practice address
- 14673 Midway Rd Ste 115
Addison, TX 75001-3933 - Phone
- (214) 810-1356
- NPI assigned
- May 13, 2009
- 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 | 61269 | TX | Primary |
Addresses
Primary practice location
14673 Midway Rd Ste 115
Addison, TX 75001-3933
Mailing address
2616 Timbercreek Dr
Plano, TX 75075-3125
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 |
|---|---|---|---|
| 61269 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360195200000",
"number": "1902030364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2616 TIMBERCREEK DR",
"city": "PLANO",
"state": "TX",
"postal_code": "750753125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14673 MIDWAY RD STE 115",
"city": "ADDISON",
"state": "TX",
"postal_code": "750013933",
"telephone_number": "214-810-1356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTERN",
"first_name": "REBECCA",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-13",
"last_updated": "2013-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "61269",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Addison, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.