Individual provider Active NPI

Christine Ann Mattingly, LCSW

  • Addiction (Substance Use Disorder) Counselor
  • Norwich, NY
National Provider Identifier
1386718567
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
R050209-1 Issued in NY
Practice address
105 Leilanis LN
Norwich, NY 13815-3540
Phone
(607) 337-1680
Fax
(607) 336-1380
NPI assigned
Nov 20, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X R050209-1 NY Primary
Clinical Social Worker 1041C0700X R050209-1 NY

Addresses

Primary practice location

105 Leilanis LN
Norwich, NY 13815-3540

Mailing address

7 Mount Pleasant Rd
Bainbridge, NY 13733-2211
Phone (607) 336-1380

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
R050209-1NYMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Chenango County PastSince May 18, 1994 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1386718567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 MOUNT PLEASANT RD",
            "city": "BAINBRIDGE",
            "state": "NY",
            "postal_code": "137332211",
            "telephone_number": "607-336-1380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 LEILANIS LN",
            "city": "NORWICH",
            "state": "NY",
            "postal_code": "138153540",
            "telephone_number": "607-337-1680",
            "fax_number": "607-336-1380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "CHRISTINE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "R050209-1",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R050209-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.