MATTHEW THOMAS HENNESSY PSYD NPI 1336191576

NPI Information

NPI: 1336191576
Provider Name: MATTHEW THOMAS HENNESSY, PSYD
Classification: Psychologist - 103TB0200X
Entity Type: Individual

Specialization: Cognitive & Behavioral

PECOS Registration: Yes

Address:
10333 EL CAMINO REAL
ATASCADERO, CA
ZIP 93423
Phone: (805) 468-2000
Get Directions

Matthew Thomas Hennessy, PSYD is a cognitive and behavioral psychologist in Atascadero, CA. The provider is a psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cognitive processing to promote meaningful change in maladaptive human behavior and thinking. Matthew Thomas Hennessy, PSYD NPI is 1336191576. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

10333 EL CAMINO REAL
ATASCADERO, CA
ZIP 93423-001
Phone: (805) 468-2000
Fax: (805) 466-6011

The NPI 1336191576 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 5/16/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103TB0200X	Psychologist	Cognitive & Behavioral	PSY17421	CALIFORNIA	Yes
2	103TC0700X	Psychologist	Clinical	PSY17421	CALIFORNIA	X
3	103TC1900X	Psychologist	Counseling	PSY17421	CALIFORNIA	X
4	103TF0200X	Psychologist	Forensic	PSY17421	CALIFORNIA	X
5	103T00000X	Psychologist		PSY17421	CALIFORNIA	X
6	103TP2701X	Psychologist	Group Psychotherapy	PSY17421	CALIFORNIA	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	OPL174210	MEDICARE ID-TYPE UNSPECIFIED
2	PSYCH	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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