Kyle G Matz, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

T0726 Issued in OR

Practice address

2713 W Harvard Ave Ste 90
Roseburg, OR 97471-2600

Phone

(541) 430-2096

Fax

(541) 637-0849

NPI assigned

Mar 25, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Roseburg Clinic, P.C.

  • Otolaryngology Physician
  • Roseburg, OR
  • NPI 1841396405
  NPD (past)

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

{
    "created_epoch": "1301011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1447559760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 398",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974700101",
            "telephone_number": "541-430-2096",
            "fax_number": "541-637-0849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2713 W HARVARD AVE STE 90",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712600",
            "telephone_number": "541-430-2096",
            "fax_number": "541-637-0849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATZ",
        "first_name": "KYLE",
        "middle_name": "G",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-25",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T0726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500646717",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melrose Mona Ellan Mask, PSS
• Samantha Ann Mason, D.O.
• Isabella J Mast
• Roland Price Matthews
• Carmen Negrete Matthis, PHARMD
• Nichole Renne Matz, BS
• Carly Mauch, PA-C
• Joe Maxey, BS
• Joy L Maxwell, RN
• Beatrice Mupenzi May

• Marriage & Family Therapist in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Marriage & Family Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.