Active NPI
Magdalena Michele Matias, LMSW
- Mental Health Counselor
- Bronx, NY
National Provider Identifier
1780060764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 093985-1
- Practice address
- 2021 Grand Concourse
Bronx, NY 10453-4304 - Phone
- (646) 221-8104
- NPI assigned
- Aug 3, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 093985-1 | NY | Primary |
Addresses
Primary practice location
2021 Grand Concourse
Bronx, NY 10453-4304
Mailing address
123 E 236TH St
Bronx, NY 10470-2111
Phone (646) 221-8104
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 |
|---|---|---|---|
| 093985-1 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438560000000",
"number": "1780060764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 E 236TH ST",
"city": "BRONX",
"state": "NY",
"postal_code": "104702111",
"telephone_number": "646-221-8104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2021 GRAND CONCOURSE",
"city": "BRONX",
"state": "NY",
"postal_code": "104534304",
"telephone_number": "646-221-8104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATIAS",
"first_name": "MAGDALENA",
"middle_name": "MICHELE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-03",
"last_updated": "2015-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "093985-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.