Marissa Mateer, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW018005 Issued in PA

Practice address

176 Virginia Ave
Rochester, PA 15074-1723

Phone

(724) 770-9095

Fax

(724) 770-9096

NPI assigned

Oct 19, 2011

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

Other identifiers 1

Other names 1

• Marissa Kaminisk Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Marissa Mateer, LLC

  • Clinical Social Worker
  • Sewickley, PA
  • NPI 1922520089

  Clinical

  NPD Authorized official

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497225600000",
    "number": "1619252962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SHENANGO AVE",
            "city": "SHARON",
            "state": "PA",
            "postal_code": "161461503",
            "telephone_number": "724-770-9095",
            "fax_number": "724-770-9096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 VIRGINIA AVE",
            "city": "ROCHESTER",
            "state": "PA",
            "postal_code": "150741723",
            "telephone_number": "724-770-9095",
            "fax_number": "724-770-9096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATEER",
        "first_name": "MARISSA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-19",
        "last_updated": "2017-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW129029",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW018005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1030340880001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "KAMINISK",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Lyle, RD
• David Patrick Madden, DNP-PMHNP
• Francheska Rose Marino
• Mario a. Grippa
• Stacy Ann Martella, PHARMD
• Robert W McMichael, CRNA
• Memaw Inc
• Kanthi Menon, M.D.
• Mental Health Association in Beaver County
• Christina A Modrovich

• Clinical Social Worker in Rochester, PA
• Providers in Rochester, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2017; 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.