Mary Mattice, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15557 Issued in FL

Practice address

359 Fenn St
Administrative Offices
Pittsfield, MA 01201-5261

Phone

(413) 629-1251

Fax

(413) 448-2198

NPI assigned

May 6, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

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.

• Direct Access Counseling & Supportive Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Arcadia, FL
  • NPI 1679011449

  Counselor

  NPD
• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Parrish, FL
  • NPI 1255376000
  NPD
• MCR Health, Inc.

  • Non-Pharmacy Dispensing Site
  • Bradenton, FL
  • NPI 1821878745
  NPD
• Ultima Rehab-FL LLC

  • Geriatric Physical Therapist
  • North Fort Myers, FL
  • NPI 1053970194
  NPD (past)

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

{
    "created_epoch": "1367798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1700221645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6302 MARKSTOWN DR APT A",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336179376",
            "telephone_number": "518-364-5849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "359 FENN ST",
            "address_2": "ADMINISTRATIVE OFFICES",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012015261",
            "telephone_number": "413-629-1251",
            "fax_number": "413-448-2198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTICE",
        "first_name": "MARY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-06",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW15557",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "15557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Massachusetts Society for the Prevention of Cruelty to Children
• Matavia Health PLLC
• Kari E Mathes, LMHC
• Chrissy Mathew, M.D
• Matthew M. Ballinger DDS, LLC
• Shaun Mattoon
• Megan Newton Mauer
• Sharon L Maxwell
• Nicole May
• Lynne M Mazzeo, CRNA

• Clinical Social Worker in Pittsfield, MA
• Providers in Pittsfield, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.