Individual provider Active NPI

Marena Matta, PSYD

  • Clinical Psychologist
  • Lubbock, TX
National Provider Identifier
1710512702
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
40505 Issued in TX
Practice address
3223 S Loop 289 Ste 416
Lubbock, TX 79423-1365
Phone
(806) 602-2815
NPI assigned
Mar 10, 2020
Last updated
Mar 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 40505 TX Primary

Addresses

Primary practice location

3223 S Loop 289 Ste 416
Lubbock, TX 79423-1365

Mailing address

3223 S Loop 289 Ste 416
Lubbock, TX 79423-1365
Phone (806) 602-2815

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20260415002172 TX Practitioner - Clinical Psychologist 7719453067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tuamokumo Consulting PLLCGroup PAC ID 1759623465, 6 clinicians

Practice addresses (Care Compare)

4003 113TH St
Lubbock, TX 79423-1979
Phone (806) 730-3458

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40505TXMDClinical Psychologist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1583798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1710512702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3223 S LOOP 289 STE 416",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794231365",
            "telephone_number": "806-602-2815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3223 S LOOP 289 STE 416",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794231365",
            "telephone_number": "806-602-2815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTA",
        "first_name": "MARENA",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-10",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "40505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.