Individual provider Active NPI

Heather Mattson, MSW, LCSW

  • Clinical Social Worker
  • Menasha, WI
National Provider Identifier
1114790086
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12431 Issued in WI
Practice address
1810 Appleton Rd
Menasha, WI 54952-1164
Phone
(920) 739-4226
Fax
(920) 739-7639
NPI assigned
Nov 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 12431 WI Primary

Addresses

Primary practice location

1810 Appleton Rd
Menasha, WI 54952-1164

Mailing address

PO Box 22308
Green Bay, WI 54305-2308
Phone (920) 436-6800

Other identifiers 2

IdentifierTypeStateIssuer
132927OtherWISTATE LICENSE
12431OtherWISTATE LICENSE

Other names 1

  • Heather Hietpas Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251117003596 WI Practitioner - Clinical Social Worker 9234620345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 22308
Green Bay, WI 54305

PO Box
Suite 22308
Green Bay, WI 54305-2308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12431WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Services of Northeast Wisconsin Inc CurrentSince Sep 30, 2025 Accepting new patients
Family Services of Northeast Wisconsin Inc CurrentSince Sep 30, 2025 Accepting new patients

Locations

1810 Appleton Rd
Menasha, WI 54952
Phone (920) 739-4226

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1114790086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22308",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052308",
            "telephone_number": "920-436-6800",
            "fax_number": "920-432-5966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 APPLETON RD",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521164",
            "telephone_number": "920-739-4226",
            "fax_number": "920-739-7639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTSON",
        "first_name": "HEATHER",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-02",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "12431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "132927",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "12431",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "HIETPAS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Menasha, WI

Sources for this page

Verify at the official NPI Registry.