Active NPI
Bobbi Jo Mattingly, LCSW
- Clinical Social Worker
- Owensboro, KY
National Provider Identifier
1588231484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 3400837A
- Practice address
- 850 E Byers Ave
Owensboro, KY 42303-6472 - Phone
- (502) 262-4489
- NPI assigned
- Jun 8, 2021
- Last updated
- Jun 8, 2021
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 3400837A | IN | Primary |
Addresses
Primary practice location
850 E Byers Ave
Owensboro, KY 42303-6472
Mailing address
850 E Byers Ave
Owensboro, KY 42303-6472
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 |
|---|---|---|---|
| 3400837A | IN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623110400000",
"number": "1588231484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 E BYERS AVE",
"city": "OWENSBORO",
"state": "KY",
"postal_code": "423036472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 E BYERS AVE",
"city": "OWENSBORO",
"state": "KY",
"postal_code": "423036472",
"telephone_number": "502-262-4489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTINGLY",
"first_name": "BOBBI",
"middle_name": "JO",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-08",
"last_updated": "2021-06-08",
"certification_date": "2021-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "3400837A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Owensboro, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.