GINO MATA LCDC-INTERN NPI 1417736521

NPI Information

  • NPI: 1417736521
  • Provider Name: GINO MATA, LCDC-INTERN
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 7510 FM 1886
    AZLE, TX
    ZIP 76020
  • Phone: (817) 448-8893

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NPI Details

Gino Mata, LCDC-INTERN is an addiction (substance use disorder) counselor in Azle, TX. Gino Mata, LCDC-INTERN NPI is 1417736521. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7510 FM 1886
AZLE, TX
ZIP 76020-054
Phone: (817) 448-8893

The enumeration date for this NPI number is 9/27/2023 and was last updated on 9/27/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)CITEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

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