Provider Demographics
NPI:1912042623
Name:MATSON, JAMES ALLEN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ALLEN
Last Name:MATSON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16439 EMBER HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-7130
Mailing Address - Country:US
Mailing Address - Phone:713-779-6300
Mailing Address - Fax:
Practice Address - Street 1:9100 SOUTHWEST FWY
Practice Address - Street 2:SUITE 225
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1519
Practice Address - Country:US
Practice Address - Phone:713-779-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0153511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical