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Kelley Mattingly, LCSW-C

Individual provider Active NPI Clinical Social Worker · Waldorf, MD

NPI 1457096059 · NPPES record last updated Oct 14, 2025

Key facts

NPI
1457096059
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
Practice address
11100 Billingsley Rd
Waldorf, MD 20602-3400
Phone
(610) 994-2968
NPI assigned
Apr 28, 2022
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
11100 Billingsley Road Opco LLC Current
since Oct 21, 2025		 Accepting new patients

Locations

11100 Billingsley Rd
Waldorf, MD 20602
Phone (202) 849-5619

2701 Renaissance Blvd
Fl 4
King of Prussia, PA 19406

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Yes

Addresses

Primary practice location

11100 Billingsley Rd
Waldorf, MD 20602-3400

Mailing address

2701 Renaissance Blvd FL 4
King of Prussia, PA 19406-2781
Phone (610) 994-2968

Other providers in Waldorf, MD

All providers in Waldorf, MD · Clinical Social Worker in Maryland

Sources for this page

Verify at the official NPI Registry.