Individual provider Active NPI

Kristine S. Matel, L.C.S.W

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1356587612
Registry record updated Dec 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34003108A Issued in IN
Practice address
9231 N Tacoma Ave
Indianapolis, IN 46240-1331
Phone
(317) 580-1642
NPI assigned
Dec 16, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34003108A IN Primary

Addresses

Primary practice location

9231 N Tacoma Ave
Indianapolis, IN 46240-1331

Mailing address

9231 N Tacoma Ave
Indianapolis, IN 46240-1331
Phone (317) 580-1642

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

LicenseStateTypeSpecialty
34003108AINMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1229385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229385600000",
    "number": "1356587612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9231 N TACOMA AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462401331",
            "telephone_number": "317-580-1642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9231 N TACOMA AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462401331",
            "telephone_number": "317-580-1642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATEL",
        "first_name": "KRISTINE",
        "middle_name": "S.",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-16",
        "last_updated": "2008-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34003108A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2008; 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.