Individual provider Active NPI

Elizabeth Anna Matola, MSW, APSW

  • Clinical Social Worker
  • Milwaukee, WI
National Provider Identifier
1750603197
Registry record updated Dec 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
127282-121 Issued in WI
Practice address
8901 W Capitol Dr
Milwaukee, WI 53222-1706
Phone
(414) 465-5753
NPI assigned
Feb 26, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2016

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 127282-121 WI Primary

Addresses

Primary practice location

8901 W Capitol Dr
Milwaukee, WI 53222-1706

Mailing address

1524 N Farwell Ave
Milwaukee, WI 53202-2329
Phone (414) 273-2220

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
127282-121WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Icf Consultants, Inc. PastSince Jul 11, 2011 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": "1267142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482192000000",
    "number": "1750603197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 N FARWELL AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532022329",
            "telephone_number": "414-273-2220",
            "fax_number": "414-273-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532221706",
            "telephone_number": "414-465-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOLA",
        "first_name": "ELIZABETH",
        "middle_name": "ANNA",
        "name_prefix": "Mrs.",
        "credential": "MSW, APSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-26",
        "last_updated": "2016-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "127282-121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.

Verify at the official NPI Registry.