Melissa Matamoros, B.A

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

145 N Eagle Rd
Havertown, PA 19083-3418

Phone

(610) 446-1861

NPI assigned

May 25, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

Practice roles

Locations

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.

• Serenity Behavioral Health LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Havertown, PA
  • NPI 1376177899
  NPD

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1023756392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3226 BIRCH HILL DR",
            "city": "TANNERSVILLE",
            "state": "PA",
            "postal_code": "183727836",
            "telephone_number": "570-688-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 N EAGLE RD",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190833418",
            "telephone_number": "610-446-1861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATAMOROS",
        "first_name": "MELISSA",
        "credential": "B.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-25",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Randolph Martin, D.M.D.
• Robyn Martin, MS
• Gina Marie Martinelli Noble, MPT, ATC
• Marianne Bernadette Martino, PSY. D.
• Amberleigh Martucci
• Lisa Jo Matherson, CRNP
• Dana Matheson
• Marielle Martino Mathews, PSYD
• Courtney Ann Matthews, B.S.L.
• Tierra Matthews, RN

• Counselor in Havertown, PA
• Providers in Havertown, PA by specialty
• Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.