Bailey Mattison

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

1841 Park Ave
New York, NY 10035-1316

Phone

(646) 459-6091

NPI assigned

Aug 4, 2010

Last updated

Aug 23, 2016By 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 2

Addresses

Other names 1

• Bailey Clark Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Agape Wellness and Family Services

  • Community/Behavioral Health Agency
  • Las Vegas, NV
  • NPI 1306263967
  Authorized official Same address or phone

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

{
    "created_epoch": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1831403658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1366 INWOOD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104523203",
            "telephone_number": "702-578-3035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100351316",
            "telephone_number": "646-459-6091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTISON",
        "first_name": "BAILEY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-04",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BAILEY",
            "last_name": "CLARK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel E. Mattila, LCSW
• Melissa Diane Mattimore I, RN, ACNP
• Sara Mattina, MSW
• James Lee Mattingly, CRNA
• Shameeka Mattis
• Juno Jessica Wendell Mattiuzzi
• Laura Anne Mattone, PNP
• Aditya Mattoo, M.D.
• Aprajita Mattoo, M.D.
• Christina Mattson

• Marriage & Family Therapist in New York, NY
• Providers in New York, NY by specialty
• Marriage & Family Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; 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.