Rebecca A. Matherly

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

254629 Issued in KY

Practice address

607 Hammond PLZ
Hopkinsville, KY 42240-4971

Phone

(270) 881-9551

Fax

(270) 885-5871

NPI assigned

Jan 9, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Rebecca Bohannon Former name

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": "1546992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1215400460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 614",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422410614",
            "telephone_number": "270-886-2205",
            "fax_number": "270-886-0392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 HAMMOND PLZ",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422404971",
            "telephone_number": "270-881-9551",
            "fax_number": "270-885-5871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3999 Fort Campbell Blvd",
            "address_purpose": "LOCATION",
            "city": "Hopkinsville",
            "state": "KY",
            "postal_code": "422404929",
            "country_code": "US",
            "telephone_number": "270-886-2205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHERLY",
        "first_name": "REBECCA",
        "middle_name": "A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-09",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "254629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "BOHANNON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marvel Cosmetic Surgery, PLLC
• Aaron Michael Mason, PHARM D
• Austin R. Mason
• Kathryn Mason
• Amy G. Maternowski, ARNP
• Morris J Matzke, RPH
• Mawa Group LLC (Sozo Integrative Health)
• Susanna Carmen May, FNP-C
• Chelsey Earnest McAllister
• Lori Denise McCalister

• Clinical Social Worker in Hopkinsville, KY
• Providers in Hopkinsville, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; 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.