Active NPI
Jacquelyn Michelle Matotek, M.A.,NCC, LPC, CCTP
- Professional Counselor
- Beaver, PA
National Provider Identifier
1033581368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC008541
- Practice address
- 250 Insurance St
Suite 304
Beaver, PA 15009-2760 - Phone
- (724) 371-6838
- NPI assigned
- Oct 26, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC008541 | PA | Primary |
Addresses
Primary practice location
250 Insurance St
Suite 304
Beaver, PA 15009-2760
Mailing address
2512 Orchard St
Beaver Falls, PA 15010-2373
Phone (724) 622-5471
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC008541 | PA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462320000000",
"number": "1033581368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2512 ORCHARD ST",
"city": "BEAVER FALLS",
"state": "PA",
"postal_code": "150102373",
"telephone_number": "724-622-5471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 INSURANCE ST",
"address_2": "SUITE 304",
"city": "BEAVER",
"state": "PA",
"postal_code": "150092760",
"telephone_number": "724-371-6838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATOTEK",
"first_name": "JACQUELYN",
"middle_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "M.A.,NCC, LPC, CCTP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-26",
"last_updated": "2016-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC008541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaver, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.