| Kristin Leigh Matas | |
|
107 Kilson Dr Ste 202 Mooresville NC 28117-8183 | |
| (704) 302-6974 | |
| Not Available |
| Full Name | Kristin Leigh Matas |
|---|---|
| Speciality | Counselor |
| Location | 107 Kilson Dr Ste 202, Mooresville, North Carolina |
| Authorized Official Name and Position | Kendall Maurer (CREDENTIALING) |
| Authorized Official Contact | 9804348649 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kristin Leigh Matas 150 Sundown Cove Dr Mooresville NC 28117-9188 Ph: (704) 302-6974 | Kristin Leigh Matas 107 Kilson Dr Ste 202 Mooresville NC 28117-8183 Ph: (704) 302-6974 |
| NPI Number | 1043075039 |
|---|---|
| Provider Enumeration Date | 02/19/2024 |
| Last Update Date | 02/19/2024 |
| Certification Date | 02/19/2024 |
| Medicare PECOS PAC ID | 6305388232 |
|---|---|
| Medicare Enrollment ID | O20240606004386 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043075039 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kristin Leigh Matas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811391832 PECOS PAC ID: 7113469040 Enrollment ID: I20240606004395 |
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