Active NPI
Tatiana M Matanzo I
- Professional Counselor
- Aurora, CO
National Provider Identifier
1609124320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC.0021017
- Practice address
- 14901 E Hampden Ave Ste 100
Aurora, CO 80014-5037 - Phone
- (720) 260-4115
- Fax
- (720) 836-6394
- NPI assigned
- Aug 28, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Professional Counselor | 101YP2500X | LPC.0021017 | CO | Primary |
Addresses
Primary practice location
14901 E Hampden Ave Ste 100
Aurora, CO 80014-5037
Mailing address
14901 E Hampden Ave Ste 100
Aurora, CO 80014-5037
Phone (720) 260-4115
Other practice location 1
C/baldorioty #12 Esq. C/georgetti
manati, PR 00674
Phone (787) 641-0773
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC.0021017 | CO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721865600000",
"number": "1609124320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14901 E HAMPDEN AVE STE 100",
"city": "AURORA",
"state": "CO",
"postal_code": "800145037",
"telephone_number": "720-260-4115",
"fax_number": "720-836-6394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14901 E HAMPDEN AVE STE 100",
"city": "AURORA",
"state": "CO",
"postal_code": "800145037",
"telephone_number": "720-260-4115",
"fax_number": "720-836-6394"
}
],
"practiceLocations": [
{
"address_1": "C/baldorioty #12 Esq. C/georgetti",
"address_purpose": "LOCATION",
"city": "manati",
"state": "PR",
"postal_code": "00674",
"country_code": "US",
"telephone_number": "787-641-0773",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MATANZO",
"first_name": "TATIANA",
"middle_name": "M",
"name_prefix": "Mrs.",
"name_suffix": "I",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-28",
"last_updated": "2024-07-25",
"certification_date": "2024-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "LPC.0021017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.