MEDICARE: KATHERINE PATTON MATTHEWS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	0099781	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700034758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE PATTON MATTHEWS

Provider Business Mailing Address
First Line	:	2820 CLIFF PALACE
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87507-2511
Country	:	US
Telephone Number	:	505-466-6629
Fax Number	:

Provider Business Practice Location Address
First Line	:	2960 RODEO PARK DR W
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-6353
Country	:	US
Telephone Number	:	505-986-9633
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2008
Last Update Date	:	09/03/2008

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Directions to “ KATHERINE PATTON MATTHEWS ” Practice Location

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