Holly Anne Mattingly, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.009307 Issued in IL

Practice address

4605 Lake Trail Dr Apt 2B
Lisle, IL 60532-1412

Phone

(630) 707-1799

NPI assigned

Jun 4, 2010

Last updated

Jun 2, 2021By 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 1

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.

• Ascent Healing, LLC

  • Community/Behavioral Health Agency
  • Winfield, IL
  • NPI 1710552229
  NPD Authorized official
• Ascent Healing Inc

  • Professional Counselor
  • Oak Brook, IL
  • NPI 1740683390
  Authorized official Same address or phone

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1053631663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 LAKE TRAIL DR APT 2B",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321412",
            "telephone_number": "630-707-1799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 LAKE TRAIL DR APT 2B",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321412",
            "telephone_number": "630-707-1799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "HOLLY",
        "middle_name": "ANNE",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-04",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.009307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip Martinez, LCPC
• Madilyn Martus
• Ambareen Masood
• Sarah Masri, PA-C, CAQ PSYCHIATRY
• Tina M Mattera, M.D.
• Daniel Matundan
• May Homemaker Services,. Inc
• John D Mazzarella, D.P.M.
• Jovonda McCall
• Sarah A. McCarthy

• Professional Counselor in Lisle, IL
• Providers in Lisle, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.