Active NPI
Sarah Spears Mattingly, CSW
- Clinical Social Worker
- Elizabethtown, KY
National Provider Identifier
1184756207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 4016
- Practice address
- 107 Cranes Roost CT
Elizabethtown, KY 42701-3650 - Phone
- (270) 765-2605
- Fax
- (270) 234-8572
- NPI assigned
- Mar 12, 2007
- Last updated
- Mar 20, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 4903 | KY | |
| Clinical Social Worker | 1041C0700X | 4016 | KY | Primary |
Addresses
Primary practice location
107 Cranes Roost CT
Elizabethtown, KY 42701-3650
Mailing address
107 Cranes Roost CT
Elizabethtown, KY 42701-3650
Phone (270) 765-2605
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000520921 | Other | KY | ANTHEM |
| 30605018 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4016 | KY | MD | Chiropractor |
| 4903 | KY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Communicare Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Bardstown, KY
- NPI 1679610117
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426809600000",
"number": "1184756207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 CRANES ROOST CT",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427013650",
"telephone_number": "270-765-2605",
"fax_number": "270-234-8572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 CRANES ROOST CT",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427013650",
"telephone_number": "270-765-2605",
"fax_number": "270-234-8572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTINGLY",
"first_name": "SARAH",
"middle_name": "SPEARS",
"credential": "CSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-12",
"last_updated": "2015-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "KY",
"license": "4903",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KY",
"license": "4016",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000520921",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30605018",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elizabethtown, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.