Provider Demographics
NPI:1023484672
Name:INMAN, MATT (MA COUNSELING)
Entity type:Individual
Prefix:
First Name:MATT
Middle Name:
Last Name:INMAN
Suffix:
Gender:M
Credentials:MA COUNSELING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 BEECAVE WOODS DR
Mailing Address - Street 2:208
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6762
Mailing Address - Country:US
Mailing Address - Phone:512-900-6564
Mailing Address - Fax:
Practice Address - Street 1:1015 BEECAVE WOODS DR
Practice Address - Street 2:208
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6762
Practice Address - Country:US
Practice Address - Phone:512-900-6564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66140101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional