Individual provider Active NPI

Mattilynn Carleen Naccarato, LMHC

  • Mental Health Counselor
  • Spokane, WA
National Provider Identifier
1912476565
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH61287204 Issued in WA
Practice address
4327 N Ash St
Spokane, WA 99205-1411
Phone
(509) 444-8200
NPI assigned
Nov 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CG60818017 WA
Mental Health Counselor 101YM0800X LH61287204 WA Primary

Addresses

Primary practice location

4327 N Ash St
Spokane, WA 99205-1411

Mailing address

611 N Iron Bridge Way
Spokane, WA 99202-4932
Phone (509) 444-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240423003806 WA Practitioner - Mental Health Counselor 9739528787 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CG60818017WAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Association of Spokane CurrentSince Mar 27, 2024 Accepting new patients
Community Health Association of Spokane CurrentSince Mar 27, 2024 Accepting new patients
Community Health Association of Spokane Current Accepting new patients
Spokane Public Schools District 81 Past Accepting new patients

Locations

4327 N Ash St
Spokane, WA 99205

611 N Iron Bridge Way
Spokane, WA 99202

1001 W 2nd Ave
Spokane, WA 99201
Phone (509) 835-1205

3919 N Maple St
Spokane, WA 99205
Phone (509) 326-6900

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/spokaneschools/r4/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1912476565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 N IRON BRIDGE WAY",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992024932",
            "telephone_number": "509-444-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4327 N ASH ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992051411",
            "telephone_number": "509-444-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NACCARATO",
        "first_name": "MATTILYNN",
        "middle_name": "CARLEEN",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG60818017",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61287204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.