Individual provider Active NPI

Ana Maria Leon Gomez Matute, MSC

  • Mental Health Counselor
  • Astoria, NY
National Provider Identifier
1407290778
Registry record updated Apr 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P85280 Issued in NY
Practice address
3636 33Rd St
Suite 500
Astoria, NY 11106-2329
Phone
(718) 426-8110
NPI assigned
Apr 17, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2013

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 P85280 NY Primary

Addresses

Primary practice location

3636 33Rd St
Suite 500
Astoria, NY 11106-2329

Mailing address

5 Great Jones St Apt 9
New York, NY 10012-1157
Phone (646) 626-9271

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
P85280NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1366156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366156800000",
    "number": "1407290778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 GREAT JONES ST APT 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100121157",
            "telephone_number": "646-626-9271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 33RD ST",
            "address_2": "SUITE 500",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111062329",
            "telephone_number": "718-426-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON GOMEZ MATUTE",
        "first_name": "ANA",
        "middle_name": "MARIA",
        "credential": "MSC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-17",
        "last_updated": "2013-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P85280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; 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.