Individual provider Active NPI

Angela Rose Matta, LCSW, LAC

  • Clinical Social Worker
  • Billings, MT
National Provider Identifier
1265741672
Registry record updated Oct 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
874 Issued in MT
Practice address
208 N Broadway Ste 423
Billings, MT 59101-1943
Phone
(406) 896-8427
NPI assigned
Oct 3, 2010
Last updated
Oct 3, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1202 MT
Clinical Social Worker 1041C0700X 874 MT Primary

Addresses

Primary practice location

208 N Broadway Ste 423
Billings, MT 59101-1943

Mailing address

3516 54TH St W
Billings, MT 59106-1044
Phone (406) 208-8959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110119000355 MT Practitioner - Clinical Social Worker 9436338746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1925 Grand Ave
Suite 123
Billings, MT 59102-2763
Phone (406) 969-5930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1202MTMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Angela Matta, LCSW, Lac, PC Multi-Specialty CurrentSince Oct 28, 2013 Accepting new patients

Locations

1925 Grand Ave
Ste 123
Billings, MT 59102
Phone (406) 969-5930

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1286064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286064000000",
    "number": "1265741672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3516 54TH ST W",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591061044",
            "telephone_number": "406-208-8959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 N BROADWAY STE 423",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591011943",
            "telephone_number": "406-896-8427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTA",
        "first_name": "ANGELA",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "LCSW, LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-03",
        "last_updated": "2010-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MT",
            "license": "1202",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

Verify at the official NPI Registry.