Debra K Matos, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12916 Issued in MD

Practice address

1604 Orlando St
Friendswood, TX 77546

Phone

(240) 888-5066

NPI assigned

Oct 31, 2006

Last updated

Dec 16, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1134205180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 ORLANDO ST",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "77546",
            "telephone_number": "240-888-5066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 ORLANDO ST",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "77546",
            "telephone_number": "240-888-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOS",
        "first_name": "DEBRA",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "12916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW-C",
            "identifier": "12916",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008304600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Michelle Martinez
• John Martinez, PTA
• Patience Martinez, RBT
• Mason Friendswood Op LLC (Friendship Haven Healthcare and Rehabilitation Center)
• Deann Janae Massey, MS, CCC-SLP
• Tiffany Diane May
• Gary Wayne Mayfield, DDS
• Joan E McBride, L.M.F.T.
• Elaine McCain, MA, LPC
• Tamara McCann, RPH

• Clinical Social Worker in Friendswood, TX
• Providers in Friendswood, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; 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.