Active NPI
Mary Ann Mattingly, MS LPC
- Professional Counselor
- Anchorage, AK
National Provider Identifier
1356429245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 338
- Practice address
- 2600 Denali St
Suite 606
Anchorage, AK 99503-2739 - Phone
- (907) 522-2010
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 338 | AK | Primary |
| Professional Counselor | 101YP2500X | P8703006 | AR |
Addresses
Primary practice location
2600 Denali St
Suite 606
Anchorage, AK 99503-2739
Mailing address
PO Box 230684
Anchorage, AK 99523-0684
Phone (907) 522-2010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2024 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P8703006 | AR | MD | Professional Counselor |
| 338 | AK | MD | Adult Psychiatric/Mental Health Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1356429245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 230684",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995230684",
"telephone_number": "907-522-2010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 DENALI ST",
"address_2": "SUITE 606",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995032739",
"telephone_number": "907-522-2010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTINGLY",
"first_name": "MARY",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "MS LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AK",
"license": "338",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AR",
"license": "P8703006",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.