JACQUELINE MATA
NPI 1700148608
Counselor - Mental Health in Monroe, CT
Active since June 15, 2012
About Jacqueline Mata NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACQUELINE MATA (NPI 1700148608) is an individual mental health provider in Monroe, Connecticut and active in the NPI registry since June 2012.
NPPES Registry Identity
NPI1700148608
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameJACQUELINE MATA
Location Address101 WILLIAM HENRY DRMonroe, CT 06468-2556
Mailing Address101 William Henry DrMonroe, CT 06468-2556 · (203) 520-2034
Phone(203) 520-2034
Sole ProprietorNo
Enumeration DateJune 15, 2012
✔ NPI 1700148608 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
101 WILLIAM HENRY DR, Monroe, CT 06468
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1700148608, enumerated as an "individual" on June 15, 2012.
The provider is located at 101 WILLIAM HENRY DR MONROE, CT 06468 and the phone number is (203) 520-2034.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
