Provider Demographics
NPI:1376837054
Name:MATTHEW ZITO & ASSOCIATES
Entity Type:Organization
Organization Name:MATTHEW ZITO & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:ZITO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, ATR-BC
Authorized Official - Phone:512-422-7563
Mailing Address - Street 1:1101 ARROW POINT DR
Mailing Address - Street 2:SUITE #212
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7737
Mailing Address - Country:US
Mailing Address - Phone:512-422-7563
Mailing Address - Fax:512-218-8444
Practice Address - Street 1:1101 ARROW POINT DR
Practice Address - Street 2:SUITE #212
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7737
Practice Address - Country:US
Practice Address - Phone:512-422-7563
Practice Address - Fax:512-218-8444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201078106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX186901801Medicaid
TXB1062081Medicare UPIN