Healthcare Provider Details
I. General information
NPI: 1225902455
Provider Name (Legal Business Name): HEALTHMATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/01/2025
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
580 LINCOLN PARK BLVD STE 344
KETTERING OH
45429-3493
US
IV. Provider business mailing address
4085 PEPPERWELL CIR
DAYTON OH
45440-3749
US
V. Phone/Fax
- Phone: 937-681-5996
- Fax:
- Phone: 937-542-9246
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QA0505X |
| Taxonomy | Adult Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEVEN
MATES
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 937-542-9246