Active NPI
Brooke Mattison, LPC
- Professional Counselor
- Mauldin, SC
National Provider Identifier
1487108452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6395
- Practice address
- 400 S Main St Ste C
Mauldin, SC 29662-2251 - Phone
- (864) 293-5025
- NPI assigned
- Aug 8, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6395 | SC | Primary |
Addresses
Primary practice location
400 S Main St Ste C
Mauldin, SC 29662-2251
Mailing address
400 S Main St Ste C
Mauldin, SC 29662-2251
Phone (864) 293-5025
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6395 | Other | SC | SOUTH CAROLINA BOARD OF COUNSELORS |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6395 | SC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indigo Skies LLC | Current | 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 and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470614400000",
"number": "1487108452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 S MAIN ST STE C",
"city": "MAULDIN",
"state": "SC",
"postal_code": "296622251",
"telephone_number": "864-293-5025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 S MAIN ST STE C",
"city": "MAULDIN",
"state": "SC",
"postal_code": "296622251",
"telephone_number": "864-293-5025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTISON",
"first_name": "BROOKE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-08",
"last_updated": "2016-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "SC",
"license": "6395",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOUTH CAROLINA BOARD OF COUNSELORS",
"identifier": "6395",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mauldin, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.