Kyle Paul Matera, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13960 Issued in FL

Practice address

110 John F Kennedy Dr Ste 118
Atlantis, FL 33462-1146

Phone

(631) 949-7434

NPI assigned

Jan 3, 2020

Last updated

Jan 3, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1578009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1235778549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11211 S MILITARY TRL APT 4221",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334367234",
            "telephone_number": "631-949-7434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 JOHN F KENNEDY DR STE 118",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334621146",
            "telephone_number": "631-949-7434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATERA",
        "first_name": "KYLE",
        "middle_name": "PAUL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-03",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "13960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ramon Martinez
• Arletta U Marunowska, MD, FACC
• Maiwand Iqbal Mateen, MD
• Ana Raquel Mateo-Bibeau, MD
• Casandra I Mateo, M.D.
• Gabriel Mattei-Gonzalez, MD
• Lauren Mattison
• Kevin Patrick McCaffrey, D.M.D., M.S.
• Melody Ann McClure, ARNP, NP-C
• Matthew Joseph McCrosson

• Clinical Social Worker in Atlantis, FL
• Providers in Atlantis, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.