Individual provider Active NPI

Joseline Karely Matias, MSW

  • Mental Health Counselor
  • Fort Wayne, IN
National Provider Identifier
1386363752
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
99112444A Issued in IN
Practice address
2013 S Anthony Blvd
Fort Wayne, IN 46803-3609
Phone
(260) 209-4529
Fax
(260) 399-9282
NPI assigned
Aug 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 99112444A IN Primary

Addresses

Primary practice location

2013 S Anthony Blvd
Fort Wayne, IN 46803-3609

Mailing address

4326 Hanna St
Fort Wayne, IN 46806-4742
Phone (260) 209-4529

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://www.therapyappointment.com/ Health Information Exchange (HIE)

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
99112444AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Courageous Healing Inc Mental Health CurrentSince Aug 28, 2022 Accepting new patients
Courageous Healing, LLC PastSince Aug 28, 2022 Accepting new patients

Locations

2013 S Anthony Blvd
Fort Wayne, IN 46803
Phone (260) 255-3514

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1386363752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4326 HANNA ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468064742",
            "telephone_number": "260-209-4529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2013 S ANTHONY BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468033609",
            "telephone_number": "260-209-4529",
            "fax_number": "260-399-9282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATIAS",
        "first_name": "JOSELINE",
        "middle_name": "KARELY",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-26",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "99112444A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.therapyappointment.com/",
            "affiliation": "N",
            "endpointDescription": "TherapyAppointment (TA) is one of the longest-running therapy focused EMRs originally built in 2008 by a group of therapists to meet the unique needs of psychologists, psychiatrists, counselors, etc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Case Notes, direct email w/ clients, billing, scheduling, etc.",
            "address_1": "2013 S Anthony Blvd",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468033609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.