Amy Mattia

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2011024387 Issued in MO

Practice address

625 Meramec Station Rd
Manchester, MO 63021-5550

Phone

(314) 266-6162

NPI assigned

Jul 21, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Karis House Community Counseling Netowrk

  • Mental Health Counselor
  • Manchester, MO
  • NPI 1497550974
  NPD Authorized official
• Karis House Community Cousneling Center

  • Counselor
  • Saint Louis, MO
  • NPI 1588057350
  NPD (past)

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

{
    "created_epoch": "1437436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1417332370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 MERAMEC STATION RD",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630215550",
            "telephone_number": "314-802-8805",
            "fax_number": "314-255-1852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 MERAMEC STATION RD",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630215550",
            "telephone_number": "314-266-6162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "829 N Hanley Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631302832",
            "country_code": "US",
            "telephone_number": "314-802-8805",
            "fax_number": "314-255-1852",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTIA",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-21",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2011024387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manchester Home Healthcare LLC.
• Manchester Home Healthcare LLC.
• Manchester Vision Associates, Inc
• Angela Marty, COTA/L
• Jaclyn Anne Mastroianni
• Bradley James Mawer, D.C.
• Elizabeth McCarthy, M.S., CCC-SLP
• Terry Michael McKenna, DDS
• McKenzie Center for Speech and Language
• Bonnie S. McKenzie, M.S.,CCC;SLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.