Active NPI
Angela Michelle Matlock, LPC
- Professional Counselor
- Atlanta, TX
National Provider Identifier
1194251074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 72799
- Practice address
- 444 PR 332
Atlanta, TX 75551-7555 - Phone
- (903) 799-0551
- NPI assigned
- May 11, 2017
- Last updated
- Mar 26, 2021
- 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 | 72799 | TX | Primary |
Addresses
Primary practice location
444 PR 332
Atlanta, TX 75551-7555
Mailing address
444 PR 332
Atlanta, TX 75551
Phone (903) 799-0551
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 72799 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616716800000",
"number": "1194251074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "444 PR 332",
"city": "ATLANTA",
"state": "TX",
"postal_code": "75551",
"telephone_number": "903-799-0551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "444 PR 332",
"city": "ATLANTA",
"state": "TX",
"postal_code": "755517555",
"telephone_number": "903-799-0551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATLOCK",
"first_name": "ANGELA",
"middle_name": "MICHELLE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-05-11",
"last_updated": "2021-03-26",
"certification_date": "2021-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "72799",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.