MEDICARE: DR. MATTHEW LUKE FERRARA PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	22796	TX
2	103TC0700X	Clinical Psychologist	22796	TX

General Provider Information

NPI Number	:	1225279623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW LUKE FERRARA PH.D.

Provider Business Mailing Address
First Line	:	4833 SPICEWOOD SPRINGS RD STE 101
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-8436
Country	:	US
Telephone Number	:	512-708-0502
Fax Number	:

Provider Business Practice Location Address
First Line	:	4833 SPICEWOOD SPRINGS RD STE 101
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-8436
Country	:	US
Telephone Number	:	512-708-0502
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2009
Last Update Date	:	03/30/2022

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