Jose Manuel Mata III, MA, LMFT-A

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

204741 Issued in TX

Practice address

2201 S W S Young Dr Ste 116a
Killeen, TX 76543-5314

Phone

(254) 213-3705

NPI assigned

Jan 10, 2023

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

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Yellow Ribbon Counseling PLLC

  • Marriage & Family Therapist
  • Killeen, TX
  • NPI 1255811485
  NPD

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

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1386358653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 S W S YOUNG DR STE 116A",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765435314",
            "telephone_number": "254-213-3705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 S W S YOUNG DR STE 116A",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765435314",
            "telephone_number": "254-213-3705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATA",
        "first_name": "JOSE",
        "middle_name": "MANUEL",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "MA, LMFT-A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-10",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "204741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Smita Maruvada, MD
• Caroline N Masaki
• Sherri Masangcay
• Kaitlin Masten
• Camille D Masters
• Kane Benjamin Mata
• Paul Mathew, M.D.
• Nia Mathis
• Peggy Jean Mathis, RN, FNP-BC
• Sarah Mathis, OTR

• Marriage & Family Therapist in Killeen, TX
• Providers in Killeen, TX by specialty
• Marriage & Family Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.