Healthcare Provider Details

I. General information

NPI: 1265382832
Provider Name (Legal Business Name): CHASITY MATOS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

344 FULTON AVE
HEMPSTEAD NY
11550-3923
US

IV. Provider business mailing address

344 FULTON AVE
HEMPSTEAD NY
11550-3923
US

V. Phone/Fax

Practice location:
  • Phone: 516-620-0622
  • Fax: 516-538-0772
Mailing address:
  • Phone: 516-620-0622
  • Fax: 516-538-0772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number130366
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: