Staci Dimattia, LCSW, CADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05248000 Issued in NJ

Practice address

2 Violet LN
Somers Point, NJ 08244-1224

Phone

(609) 442-6262

NPI assigned

May 8, 2023

Last updated

May 8, 2023By the provider in NPPES

Sex

Female

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

Enrolled in NJ

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

Medicare enrollment (NPD)

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.

• Thrive Counseling LLC

  dba Thriveworks

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  NJ

  Medicare reassignment
• Lifebulb LLC

  • Mental Health Counselor
  • Toms River, NJ
  • NPI 1699491464
  NPD (past)

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1124718861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 VIOLET LN",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "082441224",
            "telephone_number": "609-442-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 VIOLET LN",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "082441224",
            "telephone_number": "609-442-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMATTIA",
        "first_name": "STACI",
        "credential": "LCSW, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05248000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melinda S Dettinger
• Upendra S Dhanjal, MD
• Diagnostic Health Corporation (Healthsouth Diagnostic Center of Cape Atlantic)
• Diaz Pastrana Dental Associates, Inc.
• Efrain Diaz Pastrana, D.M.D.
• Pat A Dioguardo, ATC CSCS
• Justin Disciascio
• Dina Lyn Ditzel
• Jennifer Dolan, LPC, LPAT, ATR-BC
• Christine Dollard, PHARM.D., R.PH.

• Clinical Social Worker in Somers Point, NJ
• Providers in Somers Point, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.