Tashana Natasha Mattis, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

150.106199 Issued in ID

Practice address

1525 E 53Rd St Ste 501
Chicago, IL 60615-4530

Phone

(773) 888-3361

Fax

(773) 897-5766

NPI assigned

Jan 20, 2022

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 and National Provider Directory roles.

• Grounded Wellness LLC

  • Psychologist
  • Chicago, IL
  • NPI 1043776396
  NPD (past)
• Rebecca Hubbard Dba Grounded Power Psychological Consulting

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1952849564
  NPD (past)

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

{
    "created_epoch": "1642636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1093467169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5104 S KIMBARK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606153915",
            "telephone_number": "727-637-1285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E 53RD ST STE 501",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154530",
            "telephone_number": "773-888-3361",
            "fax_number": "773-897-5766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTIS",
        "first_name": "TASHANA",
        "middle_name": "NATASHA",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-20",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "150.106199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Jean Matthiesen, NP
• Lindsey Nicole Matthysse, DPT
• Colin Mattiace, MPT
• Zachary Lendall Mattice, MD
• Katrina Andrea Mattingly, M.D.
• Thomas Lloyd Mattison, LCSW
• Michelle N Mattli, DPT
• Jessica Mattox, PHARMD
• Brendan Erik Mattson, L.AC
• Bryan D. Mattson, OTR

• Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; 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.