Active NPI
Mattison Holly, LAC
- Counselor
- Scottsdale, AZ
National Provider Identifier
1770313157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LAC-22963
- Practice address
- 1375 N Scottsdale Rd Ste 200
Scottsdale, AZ 85257-3429 - Phone
- (480) 877-9284
- NPI assigned
- Aug 1, 2024
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | LAC-22963 | AZ | Primary |
Addresses
Primary practice location
1375 N Scottsdale Rd Ste 200
Scottsdale, AZ 85257-3429
Mailing address
1375 N Scottsdale Rd Ste 200
Scottsdale, AZ 85257-3429
Phone (480) 877-9284
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 |
|---|---|---|---|
| LAC-22963 | AZ | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722470400000",
"number": "1770313157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1375 N SCOTTSDALE RD STE 200",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852573429",
"telephone_number": "480-877-9284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1375 N SCOTTSDALE RD STE 200",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852573429",
"telephone_number": "480-877-9284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLY",
"first_name": "MATTISON",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-08-01",
"last_updated": "2024-08-01",
"certification_date": "2024-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "AZ",
"license": "LAC-22963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.