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

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 and National Provider Directory roles.

• SKM Therapy LLC

  • 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.