Active NPI
Carla Mathison, LCSW
- Clinical Social Worker
- Indianapolis, IN
National Provider Identifier
1861783169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34003336A
- Practice address
- 1500 North Ritter Avenue
Indianapolis, IN 46219-3027 - Phone
- (317) 621-7631
- Fax
- (317) 621-4700
- NPI assigned
- Apr 21, 2011
- Sex
- Female
- 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 | 34003336A | IN | Primary |
Addresses
Primary practice location
1500 North Ritter Avenue
Indianapolis, IN 46219-3027
Mailing address
6626 E 75TH Street
Ste 500
Indianapolis, IN 46250-2890
Phone (317) 621-7561
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395100800000",
"number": "1861783169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6626 E 75TH STREET",
"address_2": "STE 500",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462502890",
"telephone_number": "317-621-7561",
"fax_number": "317-355-6096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 NORTH RITTER AVENUE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462193027",
"telephone_number": "317-621-7631",
"fax_number": "317-621-4700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHISON",
"first_name": "CARLA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-21",
"last_updated": "2014-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34003336A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.