NPIMap

Organization Active NPI

Mattioli Mental Health Clinic PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brighton, MI
National Provider Identifier
1407648959
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MATTIOLI MENTAL HEALTH CLINIC PLLC
Practice address
10524 Grand River Rd Ste 101
Brighton, MI 48116-9559
Phone
(810) 498-9455
NPI assigned
May 20, 2025
Last updated
May 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Authorized official

Name
Dr. Anthony Ralph Mattioli, DONPI 1770161804
Title
Owner
Phone
(810) 498-9455

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary
Adult Mental Health Clinic/Center 261QM0850X NU

Addresses

Primary practice location

10524 Grand River Rd Ste 101
Brighton, MI 48116-9559

Mailing address

10524 Grand River Rd Ste 101
Brighton, MI 48116-9559
Phone (810) 498-9455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250902001517 MI Part B Supplier - Clinic/Group Practice 2264933167 Receives reassigned benefits from 1 practitioner
Practice locations: Brighton, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1747699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747699200000",
    "number": "1407648959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10524 GRAND RIVER RD STE 101",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481169559",
            "telephone_number": "810-498-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10524 GRAND RIVER RD STE 101",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481169559",
            "telephone_number": "810-498-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTIOLI MENTAL HEALTH CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-20",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A",
        "authorized_official_last_name": "MATTIOLI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "RALPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-498-9455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.