Jerome L Mattern, LCSW, LMHC,CRC,CCM

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34003823A Issued in IN

Practice address

3660 Rome Dr
Lafayette, IN 47905-4488

Phone

(765) 742-1816

Fax

(765) 742-2257

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Alpine Physicians, LLC

  • Psychiatry Physician
  • Lafayette, IN
  • NPI 1225554801
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1801987607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 ROME DR",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054488",
            "telephone_number": "765-742-1816",
            "fax_number": "765-742-2257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 ROME DR",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054488",
            "telephone_number": "765-742-1816",
            "fax_number": "765-742-2257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTERN",
        "first_name": "JEROME",
        "middle_name": "L",
        "credential": "LCSW, LMHC,CRC,CCM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34003823A",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39000332A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Alice Matheson, LCSW
• Kerri Mathew
• Bethany Mathison
• Matrix Lifecare Center Inc.
• McKinzie Matson, RBT
• Stephen J Matthews, MD
• Mattingly Center for Sight LLC
• Mattingly Center for Sight LLC
• Thomas Paul Mattingly, M.D.
• Taylor Mattox, RBT

• Clinical Social Worker in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; 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.