Jennifer Gillis Mattson, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1468 Issued in AL

Practice address

1897 Quail Holw
Auburn, AL 36830-2544

Phone

(607) 760-2550

NPI assigned

Jul 6, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Jennifer Gillis Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Clinical Psychologists, P.C.

  • Clinical Psychologist
  • Auburn, AL
  • NPI 1841221272
  NPD (past)

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

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287360000000",
    "number": "1215249339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1897 QUAIL HOLW",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368302544",
            "telephone_number": "607-760-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1897 QUAIL HOLW",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368302544",
            "telephone_number": "607-760-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIS MATTSON",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-06",
        "last_updated": "2010-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "1468",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-03-1297",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "GILLIS",
            "prefix": "DR.",
            "credential": "PHD, BCBA-D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Nancy M Gell, P.T.
• Ayzia Gholston
• Emily Gilbert, MD
• Jason Gilleland, RD
• Laura Gaston Gillikin, RD
• Brian Timothy Gillis, LMFT
• Mackenzie Ginn
• J. Scott Gleaton, LMT
• Christine M Glenn, ARNP FNP-C
• Christopher Harold Glover, DPT

• Clinical Psychologist in Auburn, AL
• Providers in Auburn, AL by specialty
• Clinical Psychologist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; 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.