Individual provider Active NPI

Annemarie Cahill Mattison, MSW, LCSW-R

  • Clinical Social Worker
  • Ithaca, NY
National Provider Identifier
1487776340
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R046776-1 Issued in NY
Practice address
1001 W Seneca St
Suite 100
Ithaca, NY 14850-3342
Phone
(607) 277-8020
NPI assigned
Apr 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R046776-1 NY Primary

Addresses

Primary practice location

1001 W Seneca St
Suite 100
Ithaca, NY 14850-3342

Mailing address

19 Chase LN
Ithaca, NY 14850-9462
Phone (607) 273-4827

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

LicenseStateTypeSpecialty
R046776-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Franziska Racker Centers Inc Past 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.

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487776340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 CHASE LN",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148509462",
            "telephone_number": "607-273-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 W SENECA ST",
            "address_2": "SUITE 100",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148503342",
            "telephone_number": "607-277-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTISON",
        "first_name": "ANNEMARIE",
        "middle_name": "CAHILL",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R046776-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.