Provider Demographics
NPI:1851168181
Name:MATOS, DARIANA (MHC-LP)
Entity Type:Individual
Prefix:
First Name:DARIANA
Middle Name:
Last Name:MATOS
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1173 FOX ST APT 3
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10459-1879
Mailing Address - Country:US
Mailing Address - Phone:347-259-3294
Mailing Address - Fax:
Practice Address - Street 1:55 MAIN ST FL 3
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-2739
Practice Address - Country:US
Practice Address - Phone:914-327-5588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health