Carolyn Clark Matherne, LMT LA#7483

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

7483 Issued in LA

Practice address

1072 Ormond Boulevard
Suite#a
Destrehan, LA 70047-3631

Phone

(985) 307-0977

NPI assigned

Jan 9, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1515456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515456000000",
    "number": "1174030332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 CLAYTON DR",
            "city": "NORCO",
            "state": "LA",
            "postal_code": "700792326",
            "telephone_number": "985-974-0955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1072 ORMOND BOULEVARD",
            "address_2": "SUITE#A",
            "city": "DESTREHAN",
            "state": "LA",
            "postal_code": "700473631",
            "telephone_number": "985-307-0977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHERNE",
        "first_name": "CAROLYN",
        "middle_name": "CLARK",
        "credential": "LMT LA#7483",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-09",
        "last_updated": "2018-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "LA",
            "license": "7483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louisiana CVS Pharmacy, L.L.C.
• Celeste Love, DMD
• Michael William Mackenzie, DDS
• Mariah Areon Magee, FNP-C
• Brittany Weimer Martin, CCC-SLP
• George Edward McGovern IV, ATC
• Wendy Anderson McNamara, NP
• Kathryn Wiggins Melancon, MD
• Courtney Gene Mesman, PHARMD
• Cody Migliore, DPT

• Massage Therapist in Destrehan, LA
• Providers in Destrehan, LA by specialty
• Massage Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2018; 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.