Elyse Cara Mazzola, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW020749 Issued in PA

Practice address

1001 Darby Rd FL 2
Havertown, PA 19083-3818

Phone

(908) 477-5101

NPI assigned

Nov 27, 2019

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

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

{
    "created_epoch": "1574812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1831735620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 BOUDWIN AVE",
            "city": "UPPER CHICHESTER",
            "state": "PA",
            "postal_code": "190613303",
            "telephone_number": "908-477-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 DARBY RD FL 2",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190833818",
            "telephone_number": "908-477-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZOLA",
        "first_name": "ELYSE",
        "middle_name": "CARA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-27",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW020749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marielle Martino Mathews, PSYD
• Courtney Ann Matthews, B.S.L.
• Tierra Matthews, RN
• Luke Francis Mattson, PHARMD
• Todd C May, D.C.
• Charles T McAnally
• Jane L. McBride, D.C.
• Sean Neumann McCallum
• Theresa Craig McCarthy, CRNP - FNP BC
• Mary T McCole, LCSW, CAS-PC

• Clinical Social Worker in Havertown, PA
• Providers in Havertown, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.