| Angela Matta, Lcsw, Lac, Pc | |
|
1925 Grand Ave Ste 123 Billings MT 59102-2763 | |
| (406) 969-5930 | |
| Not Available |
| Full Name | Angela Matta, Lcsw, Lac, Pc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1925 Grand Ave Ste 123, Billings, Montana |
| Authorized Official Name and Position | Angela Matta (PRESIDENT) |
| Authorized Official Contact | 4069695930 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Angela Matta, Lcsw, Lac, Pc 1925 Grand Ave Ste 123 Billings MT 59102-2763 Ph: () - | Angela Matta, Lcsw, Lac, Pc 1925 Grand Ave Ste 123 Billings MT 59102-2763 Ph: (406) 969-5930 |
| NPI Number | 1164849139 |
|---|---|
| Provider Enumeration Date | 03/27/2014 |
| Last Update Date | 03/27/2014 |
| Medicare PECOS PAC ID | 5799904512 |
|---|---|
| Medicare Enrollment ID | O20140910000125 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164849139 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 874 (Montana) | Primary |
| Provider Name | Angela R Matta |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265741672 PECOS PAC ID: 9436338746 Enrollment ID: I20110119000355 |
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