Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gino Mata, LCDC-INTERN

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1417736521

Gino Mata, LCDC-INTERN is an Addiction (Substance Use Disorder) Counselor in Azle, Texas. Practices as a sole proprietor. Licensed in Texas.

Licensed in
TX
In the registry since
2023

Practice location Address checks out

7510 Fm 1886
Azle, TX 76020-1054
Phone: (817) 448-8893
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence CI (TX)

Record details

NPI number1417736521
Entity typeIndividual (Type 1)
GenderMale
Credentials LCDC-INTERN
Sole proprietorYes
NPI enumeratedSeptember 27, 2023
Last updated in NPPESSeptember 27, 2023
Certification dateSeptember 27, 2023
Mailing address7510 Fm 1886, Azle, TX 76020-1054

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