Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Theresa Marie Matocha, LISCW

Individual provider Mental Health Counselor · NPI 1639415300

Theresa Marie Matocha, LISCW is a Clinical Social Worker in Eureka, California. Qualified in 1990, 36 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Vermont.

Years since qualifying
36
Licensed in
VT
In the registry since
2012
Specialties on file
2
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Practice location Address checks out

3015 Hubbard Ln Ste 7
Eureka, CA 95501-4803
Phone: (802) 425-8101
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 089.0089650 (VT)
Mental Health Counselor Taxonomy 101YM0800X · Licence 089.0089650 (VT)

Record details

NPI number1639415300
Entity typeIndividual (Type 1)
GenderFemale
Credentials LISCW
Sole proprietorYes
NPI enumeratedDecember 27, 2012
Last updated in NPPESNovember 10, 2021
Certification dateNovember 10, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1990 (36 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Eureka