Jessica Nicole Matala, LGSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

BP00944408 Issued in WV

Practice address

509 Lake St
Morgantown, WV 26505-3312

Phone

(304) 685-8967

NPI assigned

Sep 4, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1346716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421366400000",
    "number": "1548519762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 LAKE ST",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265053312",
            "telephone_number": "304-685-8967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 LAKE ST",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265053312",
            "telephone_number": "304-685-8967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATALA",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "LGSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-04",
        "last_updated": "2015-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WV",
            "license": "BP00944408",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": "SW129846",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cory Massart
• Eric Massey, M.D.
• Greta Hanks Massey, MD
• Rachel Masters, FNP-C
• Robin Masters
• Karen Matar, MD
• Russell E Mathews, CNNP
• Margaret Mary Mathewson, MD
• Sharon Mathis
• Brittney Matlick, MS, LPC, LMFT

• Social Worker in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2015; 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.