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General NPI Number Information
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NPI Number | 1568105070
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Entity Type | Individual
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Provider Name | ALEJANDRA MATA MA, LPC ASSOCIATE
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Gender | Female
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Dates
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Enumeration Date | 04/14/2022
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Last Update Date | 02/09/2023
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Provider Practice Location Address
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Address Line | 3440 PARKWOOD BLVD. BUILDING D SUITE 401
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City | FRISCO
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State | TX
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Zip | 75034
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Country | US
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Telephone | 214-989-6627
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Fax |
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Provider Business Mailing Address
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Address Line | 2116 COLUMBIA DR
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City | RICHARDSON
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State | TX
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Zip | 75081-3207
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Country | US
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Telephone | 214-450-2999
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 84431
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 84431
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License Number State | TX
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