Organization Active NPI

Matresa Wooding LCSW PLLC

  • Clinical Social Worker
  • Port Arthur, TX
National Provider Identifier
1902237480
Registry record updated Feb 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14647 Issued in TX
Legal business name
MATRESA WOODING LCSW PLLC
Practice address
7980 Anchor Dr Ste 100a
Port Arthur, TX 77642-8267
Phone
(409) 727-0014
Fax
(409) 727-0024
NPI assigned
Dec 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2017

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

Authorized official

Name
Matresa WoodingNPI 1336389584
Title
Sole MBR
Phone
(409) 727-0014

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 14647 TX Primary

Addresses

Primary practice location

7980 Anchor Dr Ste 100a
Port Arthur, TX 77642-8267

Mailing address

7980 Anchor Dr Ste 100a
Port Arthur, TX 77642-8267
Phone (409) 727-0014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140402000455 TX Part B Supplier - Clinic/Group Practice 1850522053 Receives reassigned benefits from 1 practitioner
Practice locations: Port Arthur, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1386547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487894400000",
    "number": "1902237480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7980 ANCHOR DR STE 100A",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776428267",
            "telephone_number": "409-727-0014",
            "fax_number": "409-727-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7980 ANCHOR DR STE 100A",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776428267",
            "telephone_number": "409-727-0014",
            "fax_number": "409-727-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATRESA WOODING LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-09",
        "last_updated": "2017-02-24",
        "status": "A",
        "authorized_official_last_name": "WOODING",
        "authorized_official_first_name": "MATRESA",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "409-727-0014"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "14647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Arthur, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.