Active NPI
Matthew Mayock
- Marriage & Family Therapist
- Twin Falls, ID
National Provider Identifier
1790535482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFTI-10181
- Practice address
- 762 Falls Ave
Twin Falls, ID 83301-3316 - Phone
- (208) 258-7681
- Fax
- (208) 907-0874
- NPI assigned
- Mar 25, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFTI-10181 | ID | Primary |
Addresses
Primary practice location
762 Falls Ave
Twin Falls, ID 83301-3316
Mailing address
762 Falls Ave
Twin Falls, ID 83301-3316
Phone (208) 258-7681
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 |
|---|---|---|---|
| MFTI-10181 | ID | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aspen Grove Family Therapy, Inc | Marriage & Family Therapist | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Marriage & Family Therapist
- Twin Falls, ID
- NPI 1366905416
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711324800000",
"number": "1790535482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "762 FALLS AVE",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833013316",
"telephone_number": "208-258-7681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "762 FALLS AVE",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833013316",
"telephone_number": "208-258-7681",
"fax_number": "208-907-0874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYOCK",
"first_name": "MATTHEW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-25",
"last_updated": "2024-03-25",
"certification_date": "2024-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "ID",
"license": "MFTI-10181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Twin Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.