Active NPI
Kimberly Ann Matoka, MA, LPC
- Professional Counselor
- Phoenix, AZ
National Provider Identifier
1942494653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-11602
- Practice address
- 11022 S 51St St Ste 202
Phoenix, AZ 85044-4307 - Phone
- (602) 758-9788
- NPI assigned
- Sep 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-11602 | AZ | Primary |
Addresses
Primary practice location
11022 S 51St St Ste 202
Phoenix, AZ 85044-4307
Mailing address
11022 S 51St St Ste 202
Phoenix, AZ 85044-4307
Phone (602) 758-9788
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-11602 | AZ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188950400000",
"number": "1942494653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11022 S 51ST ST STE 202",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850444307",
"telephone_number": "602-758-9788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11022 S 51ST ST STE 202",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850444307",
"telephone_number": "602-758-9788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATOKA",
"first_name": "KIMBERLY",
"middle_name": "ANN",
"credential": "MA, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-05",
"last_updated": "2007-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC-11602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.