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NPI Code Detail

MEDICARE: MATTHEW MAYA

MEDICARE: MATTHEW MAYA
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1568322022
Entity Type Code : Organization
Provider Name (Legal Business Name) : MATTHEW MAYA
Provider Business Mailing Address
First Line : 3778 W PURE NIRVANA LN
Second Line :
City : HERRIMAN
State : UT
Zip : 84096-2602
Country : US
Telephone Number : 801-699-1759
Fax Number :
Provider Business Practice Location Address
First Line : 11175 S REDWOOD RD
Second Line :
City : SOUTH JORDAN
State : UT
Zip : 84095-8208
Country : US
Telephone Number : 801-699-1759
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MATTHEW MAYA
Credential : LCSW
Telephone Number : 801-699-1759
Provider Enumeration Date : 11/17/2025
Last Update Date : 01/05/2026

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