Provider Demographics
NPI:1558979401
Name:MATEI, ANA MARIA (LPC)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:MARIA
Last Name:MATEI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6515 SANGER AVE STE 21
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-7806
Mailing Address - Country:US
Mailing Address - Phone:254-722-1425
Mailing Address - Fax:
Practice Address - Street 1:6515 SANGER AVE STE 21
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-7806
Practice Address - Country:US
Practice Address - Phone:254-722-1425
Practice Address - Fax:903-872-2125
Is Sole Proprietor?:No
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80526101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional