1821200999 NPI number — UNITING HANDS COUNSELING & CONSULTATION SERVICES JAVIER MATOS LCSW PC

Table of content: (NPI 1821200999)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821200999 NPI number — UNITING HANDS COUNSELING & CONSULTATION SERVICES JAVIER MATOS LCSW PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNITING HANDS COUNSELING & CONSULTATION SERVICES JAVIER MATOS LCSW PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
JAVIER M. MATOS
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821200999
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/29/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
60-14 60TH STREET
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
MASPETH
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11378-3410
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-366-6252
Provider Business Mailing Address Fax Number:
718-366-6253

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
60-14 60TH STREET
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
MASPETH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11378-3410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-366-6252
Provider Business Practice Location Address Fax Number:
718-366-6253
Provider Enumeration Date:
05/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MATOS
Authorized Official First Name:
JAVIER
Authorized Official Middle Name:
MILTON
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
718-366-6252

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  069411 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 02209263 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1275559965 . This is a "INDIVIDUAL NPI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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