Arthur Laclede Davalos-Matthews, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-10461 Issued in AZ

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

Sex

Male

Sole proprietor

Yes

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

Practice roles

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

• Iora Senior Health, LLC

  • Internal Medicine Physician
  • Surprise, AZ
  • NPI 1952896235
  NPD (past)

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": []
}

• Dash Transport Services LLC
• David Dastrup, M.S.
• Syna Daudfar, DO
• Lisa J Daughters
• Rushabh Kumar Daulat, MD
• Randi Elizabeth Davenport
• Sally Davey, PSY.D.
• David C Johnson MD PC
• David J. Grossklaus, M.D.,P.C.
• David Johnson MD PLLC

• All providers in Mesa, AZ
• Professional Counselor in Arizona

• 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.

Verify at the official NPI Registry.