Active NPI
Paul Mattson
- Social Worker
- Livonia, MI
National Provider Identifier
1295071371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6802069955
- Practice address
- 39111 6 Mile Rd
Suite 101
Livonia, MI 48152-3926 - Phone
- (586) 940-9722
- NPI assigned
- Dec 18, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6802069955 | MI | Primary |
Addresses
Primary practice location
39111 6 Mile Rd
Suite 101
Livonia, MI 48152-3926
Mailing address
28362 Forestbrook Dr
Farmington Hills, MI 48334-5213
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6802069955 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355788800000",
"number": "1295071371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28362 FORESTBROOK DR",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483345213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39111 6 MILE RD",
"address_2": "SUITE 101",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481523926",
"telephone_number": "586-940-9722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTSON",
"first_name": "PAUL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-12-18",
"last_updated": "2012-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6802069955",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.