Stacey Ann Matan

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

009211 Issued in CT

Practice address

132 Misty Mountain Rd
Berlin, CT 06037-2748

Phone

(203) 214-3191

NPI assigned

Mar 17, 2025

Last updated

Mar 17, 2025By 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

Enrolled in CT

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

Specialty

Clinical Social Worker

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mellahealth LLCGroup PAC ID 9032528658, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mellahealth LLC

  • Community/Behavioral Health Agency
  • West Hartford, CT
  • NPI 1477158046

  Clinical

  Medicare reassignment Care Compare group NPD
• Ruby Psychiatric Services, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • West Hartford, CT
  • NPI 1295564425
  NPD (past)

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

{
    "created_epoch": "1742169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1144020462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 MISTY MOUNTAIN RD",
            "city": "BERLIN",
            "state": "CT",
            "postal_code": "060372748",
            "telephone_number": "203-214-3191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 MISTY MOUNTAIN RD",
            "city": "BERLIN",
            "state": "CT",
            "postal_code": "060372748",
            "telephone_number": "203-214-3191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATAN",
        "first_name": "STACEY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-17",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "009211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hallie Elizabeth Mancini
• Jonathan Maneen, DPT
• Michael Maroon, D.M.D.
• Jessica Lynn Maroto
• Amanda L Marrotte, LMFT
• Matus Family Dentistry
• Medstar Surgical & Breathing Equipment, Inc. (Genox Homecare)
• Ariel Methoxha
• Mindful Growth Unlimited
• Margaret Mirabella-Pimer

• Clinical Social Worker in Berlin, CT
• Providers in Berlin, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.