Active NPI
Arthur Laclede Davalos-Matthews, LPC
- Professional Counselor
- Mesa, AZ
National Provider Identifier
1346579877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-10461
- Practice address
- 5110 E Southern Ave
Mesa, AZ 85206-2791 - Phone
- (480) 295-8072
- Fax
- (844) 621-8047
- NPI assigned
- Dec 11, 2009
- Reactivated
- Mar 30, 2022
- Last updated
- Mar 31, 2022
- Sex
- Male
- 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 | LPC-10461 | AZ | Primary |
Addresses
Primary practice location
5110 E Southern Ave
Mesa, AZ 85206-2791
Mailing address
1237 S Val Vista Dr
Suite 103
Mesa, AZ 85204-6401
Phone (480) 238-5841
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 |
|---|---|---|---|
| LPC-10461 | AZ | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iora Senior Health, LLC | Past | Accepting new patients |
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": "1260489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648684800000",
"number": "1346579877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1237 S VAL VISTA DR",
"address_2": "SUITE 103",
"city": "MESA",
"state": "AZ",
"postal_code": "852046401",
"telephone_number": "480-238-5841",
"fax_number": "480-396-0532"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5110 E SOUTHERN AVE",
"city": "MESA",
"state": "AZ",
"postal_code": "852062791",
"telephone_number": "480-295-8072",
"fax_number": "844-621-8047"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVALOS-MATTHEWS",
"first_name": "ARTHUR",
"middle_name": "LACLEDE",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-12-11",
"last_updated": "2022-03-31",
"certification_date": "2022-03-31",
"deactivation_date": "2018-07-13",
"reactivation_date": "2022-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC-10461",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.