Leslie a.Mellor Mattis, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1024378 Issued in MA

Practice address

161 S Huntington Ave
Jamaica Plain, MA 02130-4885

Phone

(617) 264-5357

Fax

(617) 232-7925

NPI assigned

Jul 30, 2007

Last updated

Jul 30, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185753600000",
    "number": "1760672307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 S HUNTINGTON AVE",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304885",
            "telephone_number": "617-264-5357",
            "fax_number": "617-232-7925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 S HUNTINGTON AVE",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304885",
            "telephone_number": "617-264-5357",
            "fax_number": "617-232-7925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTIS",
        "first_name": "LESLIE A.MELLOR",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2007-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1024378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Matherly, OD
• Brittany Michelle Mathes Winnicki, PHD
• Diane Matos
• Kazune Matsuoka
• Catherine Matthews
• Bela T Matyas, M.D.
• Kaylie Mavricz
• Barbara Maxwell, M.D.
• Clionagh MC Laughlin
• Clare McBee, LICSW

• Clinical Social Worker in Jamaica Plain, MA
• Providers in Jamaica Plain, 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 Jul 30, 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.