William Mattingly

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2017041348 Issued in MO

Practice address

12166 Old Big Bend Rd Ste 204
Kirkwood, MO 63122-6836

Phone

(314) 822-8888

NPI assigned

Apr 2, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Carepoint Christian Counseling, LLC

  • Professional Counselor
  • Saint Louis, MO
  • NPI 1023394319
  Medicare reassignment NPD

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1407352115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12166 OLD BIG BEND RD STE 204",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631226836",
            "telephone_number": "314-822-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12166 OLD BIG BEND RD STE 204",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631226836",
            "telephone_number": "314-822-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-02",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2017041348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Jane Lane LMFT LLC
• Dylan Mason, PROVISIONAL BCABA
• Katherine Mason, LMSW
• Mark A Mason, MD
• Andrea Michele Mattingly, BA
• Daniel T Maul, LPTA
• Morton Jonathan May, PH.D.
• Melinda Maylee, M.ED, PLPC
• Laura Anne McAteer, DC
• Jeremy Lawrence McCarver, DO

• Professional Counselor in Kirkwood, MO
• Providers in Kirkwood, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.