Candyse Anne Matassa, IBCLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

L-108612 Issued in LA

Practice address

5848 Menlo Dr
Baton Rouge, LA 70808-5047

Phone

(225) 341-2411

NPI assigned

Oct 18, 2020

Last updated

Oct 18, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stork Maternity Consulting

  • Lactation Consultant (Registered Nurse)
  • Baton Rouge, LA
  • NPI 1316559040
  NPD

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

{
    "created_epoch": "1602979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602979200000",
    "number": "1801495296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18201 PINE RIDGE DR",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707693473",
            "telephone_number": "225-610-9217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5848 MENLO DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708085047",
            "telephone_number": "225-341-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATASSA",
        "first_name": "CANDYSE",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-18",
        "last_updated": "2020-10-18",
        "certification_date": "2020-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "LA",
            "license": "L-108612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allie Elizabeth Massey, SLP
• Billy Roy Massey, MOT, OTR/L
• Victoria Geiger Massey, PA
• Rebecca A Massirer, PT
• Mastology Center, Inc
• Brandi Maten, PLPC
• Trishana M Matharu, APRN, FNP-C
• Donovan Matherne, FNP-C
• Zachary Cole Matherne, CRNA
• Kevin Joseph Mathew, PT, DPT

• Lactation Consultant (Non-RN) in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Lactation Consultant (Non-RN) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2020; 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.