Active NPI
Joseline Karely Matias, MSW
- Mental Health Counselor
- Fort Wayne, IN
National Provider Identifier
1386363752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 99112444A
- 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
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 |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 99112444A | IN | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Courageous Healing Inc | Mental Health | Current | Accepting new patients |
| Courageous Healing, LLC | Past | 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.
-
- Mental Health Counselor
- Fort Wayne, IN
- NPI 1003444985
-
- Community/Behavioral Health Agency
- Fort Wayne, IN
- NPI 1922419852
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.