Kristina Nichol Mattingly, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34007303A Issued in IN

Practice address

2704 Washington Ave Ste 2
Vincennes, IN 47591-3668

Phone

(812) 615-9208

NPI assigned

Aug 30, 2013

Last updated

Jan 9, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• SKM Therapy LLC

  dba Bluebird Mental Health

  • Clinical Social Worker
  • Vincennes, IN
  • NPI 1649165069
  NPD (past)
• Touchstone Therapy LLC

  • Community/Behavioral Health Agency
  • Princeton, IN
  • NPI 1366042152

  Clinical

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1377820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1013341601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3276",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477313276",
            "telephone_number": "812-473-0181",
            "fax_number": "812-492-6498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 WASHINGTON AVE STE 2",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475913668",
            "telephone_number": "812-615-9208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "KRISTINA",
        "middle_name": "NICHOL",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-30",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33006552A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007303A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martha Ann Taylor
• Ardella Rae Martin, CASE MANAGER
• Bethany Nicole Martin
• Henry J Matick, D.O.
• Kyle A Matsel, PT, DPT
• Leticia Maxey
• William K Mayfield, MD
• Steven Michael Maynard, M.D.
• Tiffany D McCandless, AUDIOLOGIST
• Holly McCarter, PMHNP-BC

• Clinical Social Worker in Vincennes, IN
• Providers in Vincennes, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.