NPIMap

Organization Active NPI

Matt 25 Inc.

Doing business as Life Skills Learning Center

  • Professional Counselor
  • Clovis, NM
National Provider Identifier
1609001684
Registry record updated May 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0153271 Issued in NM
Legal business name
MATT 25 INC.
Doing business as
Life Skills Learning Center
Practice address
1200 Thornton St Ste a
Clovis, NM 88101-5508
Phone
(575) 763-4400
Fax
(575) 935-0400
NPI assigned
May 20, 2009
Last updated
May 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2021

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

Authorized official

Name
Mr. Steve Reshetar
Title
Director
Phone
(575) 763-4400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0153271 NM Primary

Addresses

Primary practice location

1200 Thornton St Ste a
Clovis, NM 88101-5508

Mailing address

1200 Thornton St Ste a
Clovis, NM 88101-5508
Phone (575) 763-4400

Other names 1

  • Life Skills Learning Center Doing business as

National Provider Directory

National Provider Directory

Locations

1200 N Thornton St
Ste A
Clovis, NM 88101
Phone (575) 763-4400

1200 N Thornton St
Ste H
Clovis, NM 88101
Phone (575) 935-4411

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620432000000",
    "number": "1609001684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 THORNTON ST STE A",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881015508",
            "telephone_number": "575-763-4400",
            "fax_number": "575-935-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 THORNTON ST STE A",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881015508",
            "telephone_number": "575-763-4400",
            "fax_number": "575-935-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATT 25 INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-20",
        "last_updated": "2021-05-08",
        "certification_date": "2021-05-08",
        "status": "A",
        "authorized_official_last_name": "RESHETAR",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "575-763-4400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "0153271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life Skills Learning Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Life Skills Learning Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clovis, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2021; 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.