Paul Bernard Matens, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C0732 Issued in MS

Practice address

1500 E. Woodrow Wilson Dr.
Department of Veterans Affairs Medical Center (586/122
Jackson, MS 39216-5591

Phone

(601) 362-4471

Fax

(601) 368-4093

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043302003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 EAST WOODROW WILSON DRIVE",
            "address_2": "DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER (586/122)",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165591",
            "telephone_number": "601-362-4471",
            "fax_number": "601-368-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E. WOODROW WILSON DR.",
            "address_2": "DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER (586/122",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165591",
            "telephone_number": "601-362-4471",
            "fax_number": "601-368-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATENS",
        "first_name": "PAUL",
        "middle_name": "BERNARD",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C0732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Jackson, MS
• Providers in Jackson, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.