Individual provider Active NPI

Matthew William Kizaur, MA, LPC

  • Mental Health Counselor
  • Toledo, OH
National Provider Identifier
1538811336
Registry record updated Jan 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C.2203990 Issued in OH
Practice address
2532 Meadowwood Dr
Toledo, OH 43606-3137
Phone
(419) 367-9646
NPI assigned
Jan 23, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 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 C.2203990 OH Primary

Addresses

Primary practice location

2532 Meadowwood Dr
Toledo, OH 43606-3137

Mailing address

2532 Meadowwood Dr
Toledo, OH 43606-3137
Phone (419) 367-9646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20250314001067 OH Practitioner - Mental Health Counselor 1557883949 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
C.2203990OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kizaur Counseling Mental Health CurrentSince Dec 29, 2024 Accepting new patients

Locations

3454 Oak Alley Ct
Ste 400
Toledo, OH 43606
Phone (419) 260-8993

Organizations & group practices 1

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": "1642896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642896000000",
    "number": "1538811336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2532 MEADOWWOOD DR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063137",
            "telephone_number": "419-367-9646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2532 MEADOWWOOD DR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063137",
            "telephone_number": "419-367-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIZAUR",
        "first_name": "MATTHEW",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-23",
        "last_updated": "2022-01-23",
        "certification_date": "2022-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.2203990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.