Individual provider Active NPI

Amanda Catherine Mattick, MA, LMHC, CAP

  • Addiction (Substance Use Disorder) Counselor
  • Melbourne, FL
National Provider Identifier
1376909796
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
3270 Suntree Blvd
Suite 102C
Melbourne, FL 32940
Phone
(320) 593-0759
NPI assigned
Jan 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

3270 Suntree Blvd
Suite 102C
Melbourne, FL 32940

Mailing address

351 Lake Victoria Circle
Melbourne, FL 32940
Phone (772) 475-6545

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
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Mindset Counseling Solutions 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1376909796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 LAKE VICTORIA CIRCLE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32940",
            "telephone_number": "772-475-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3270 SUNTREE BLVD",
            "address_2": "SUITE 102C",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32940",
            "telephone_number": "320-593-0759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTICK",
        "first_name": "AMANDA",
        "middle_name": "CATHERINE",
        "name_prefix": "Mrs.",
        "credential": "MA, LMHC, CAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.