Elli Marie Matkin, LCSW, ROLFER

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

BBH-LCSW-LIC-55311 Issued in MT

Practice address

210 N Higgins Ave Ste 220
Missoula, MT 59802-4443

Phone

(509) 540-2418

NPI assigned

Sep 26, 2018

Sex

Female

Sole proprietor

Yes

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

Enrolled in MT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1841775772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 SHERWOOD ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598022301",
            "telephone_number": "509-540-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N HIGGINS AVE STE 220",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024443",
            "telephone_number": "509-540-2418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1120 Cedar St",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598023911",
            "country_code": "US",
            "telephone_number": "406-541-4673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATKIN",
        "first_name": "ELLI",
        "middle_name": "MARIE",
        "credential": "LCSW, ROLFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-26",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-55311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tana Lynn Mathis, PHARM-D
• Dana Mato, PSY.D.
• Carmelita Ann Matt, MSW, SWLC
• Matthew D Munding, MD, PLLC
• Klare Matthew, LAT, ATC
• Lara Mattson Radle, L.C.P.C.

• Clinical Social Worker in Missoula, MT
• Providers in Missoula, MT by specialty
• Clinical Social Worker in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.

Verify at the official NPI Registry.