Individual provider Active NPI

Matthew Wattay, LPC

  • Professional Counselor
  • Mesa, AZ
National Provider Identifier
1467736447
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-13372 Issued in AZ
Practice address
2204 S Dobson Rd Ste 102
Mesa, AZ 85202-6457
Phone
(602) 230-7373
Fax
(480) 628-8577
NPI assigned
Oct 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC-13372 AZ Primary

Addresses

Primary practice location

2204 S Dobson Rd Ste 102
Mesa, AZ 85202-6457

Mailing address

3101 N Central Ave Ste 550
Phoenix, AZ 85012-2635
Phone (602) 230-7373

Other practice location 1

3330 N 2nd St Ste 601
Phoenix, AZ 85012-2395
Phone (602) 230-7373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240116000200 AZ Practitioner - Mental Health Counselor 1658723648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Denova Collaborative Health, LLCGroup PAC ID 2466437736, 141 clinicians

Practice addresses (Care Compare)

2204 S Dobson Rd
Suite 102
Mesa, AZ 85202-6457
Phone (602) 230-7373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Denova Collaborative Health, LLC Professional CurrentSince Jan 1, 2024 Accepting new patients
Denova Collaborative Health, LLC CurrentSince Jan 1, 2024 Accepting new patients
Denova Collaborative Health, LLC Current Accepting new patients
Denova Collaborative Health, LLC Past Accepting new patients

Locations

235 W Western Ave
Avondale, AZ 85323
Phone (623) 772-5091

2204 S Dobson Rd
Mesa, AZ 85202
Phone (480) 757-6457

2120 W Guadalupe Rd
Ste 6
Mesa, AZ 85202
Phone (480) 629-8577

2204 S Dobson Rd
Ste 201
Mesa, AZ 85202
Phone (602) 374-4410

2204 S Dobson Rd
Ste 102
Mesa, AZ 85202

3620 N 3rd St
Phoenix, AZ 85012
Phone (602) 329-8250

3033 N Central Ave
Ste 700
Phoenix, AZ 85012
Phone (602) 281-7289

3330 N 2nd St
Ste 601
Phoenix, AZ 85012
Phone (602) 234-3444

77 E Columbus Ave
Ste 210
Phoenix, AZ 85012

3101 N Central Ave
Ste 500
Phoenix, AZ 85012

926 E McDowell Rd
Ste 105
Phoenix, AZ 85006
Phone 6022307373229

9014 S Central Ave
Phoenix, AZ 85042
Phone (602) 384-8820

3101 N Central Ave
Ste 550
Phoenix, AZ 85012

750 E Thunderbird Rd
Ste 13
Phoenix, AZ 85022
Phone (602) 682-7455

750 E Thunderbird Rd
Ste 1
Phoenix, AZ 85022
Phone (602) 942-8512

Organizations & group practices 4

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": "1317945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1467736447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 N CENTRAL AVE STE 550",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122635",
            "telephone_number": "602-230-7373",
            "fax_number": "602-682-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 S DOBSON RD STE 102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852026457",
            "telephone_number": "602-230-7373",
            "fax_number": "480-628-8577"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3330 N 2nd St Ste 601",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850122395",
            "country_code": "US",
            "telephone_number": "602-230-7373",
            "fax_number": "602-230-5105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATTAY",
        "first_name": "MATTHEW",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-07",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-13372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.