Active NPI
Matthew Ronald Attebury, LCSW
- Clinical Social Worker
- Princeton, IN
National Provider Identifier
1811647464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34009524A
- Practice address
- 108 N Main St
Princeton, IN 47670-1540 - Phone
- (812) 753-1039
- NPI assigned
- Mar 26, 2022
- Last updated
- Feb 11, 2025
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34009524A | IN | Primary |
Addresses
Primary practice location
108 N Main St
Princeton, IN 47670-1540
Mailing address
108 N Main St
Princeton, IN 47670-1540
Phone (812) 753-1039
Other practice location 1
123 N McCreary St
Fort Branch, IN 47648-1313
Phone (812) 753-1039
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Tulip Tree Family Health Care
- Federally Qualified Health Center (FQHC)
- Fort Branch, IN
- NPI 1932225372
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739232000000",
"number": "1811647464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 N MAIN ST",
"city": "PRINCETON",
"state": "IN",
"postal_code": "476701540",
"telephone_number": "812-753-1039",
"fax_number": "812-753-1122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 N MAIN ST",
"city": "PRINCETON",
"state": "IN",
"postal_code": "476701540",
"telephone_number": "812-753-1039"
}
],
"practiceLocations": [
{
"address_1": "123 N McCreary St",
"address_purpose": "LOCATION",
"city": "Fort Branch",
"state": "IN",
"postal_code": "476481313",
"country_code": "US",
"telephone_number": "812-753-1039",
"fax_number": "812-753-1122",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ATTEBURY",
"first_name": "MATTHEW",
"middle_name": "RONALD",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-26",
"last_updated": "2025-02-11",
"certification_date": "2025-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34009524A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Princeton, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.