Kathryn Churchill Mattison, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1032748 Issued in MA

Practice address

20 Main St
Suite 2D
Leominster, MA 01453-5530

Phone

(978) 466-5777

Fax

(978) 466-5887

NPI assigned

Oct 16, 2007

Sex

Female

Sole proprietor

Yes

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 and National Provider Directory roles.

• Balance Counseling, LLC

  • Clinical Social Worker
  • Leominster, MA
  • NPI 1073897617
  NPD (past)

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1841489754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MAIN STREET",
            "address_2": "CAYA LLC SUITE 2D",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-466-5777",
            "fax_number": "978-466-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MAIN ST",
            "address_2": "SUITE 2D",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014535530",
            "telephone_number": "978-466-5777",
            "fax_number": "978-466-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTISON",
        "first_name": "KATHRYN",
        "middle_name": "CHURCHILL",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-16",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1032748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mass Lung & Allergy, PC.
• Mass Optometric Associates, PLLC
• Daron C Massey, MD
• Maritssa Mathieu
• Leslie Kim Matilainen, LMHC
• Paula Hanney Mattson
• Karen Maypother
• Edna McAddy, M.D.
• Paul James McCabe, MD
• Alice M. McCarthy, P.A.

• Clinical Social Worker in Leominster, MA
• Providers in Leominster, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.