Ellice Lynn Matza, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

002299 Issued in CT

Practice address

493 Fountain St
New Haven, CT 06515-1830

Phone

(518) 233-1152

NPI assigned

Jul 11, 2007

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

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": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1962600973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "493 FOUNTAIN STREET",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065151830",
            "telephone_number": "203-387-0270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "493 FOUNTAIN ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065151830",
            "telephone_number": "518-233-1152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATZA",
        "first_name": "ELLICE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0182851",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "002299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austin Kyle Mattox, MD, PHD
• Richard H Mattson, MD
• Christina Matulis, MD
• Irene Maturo, RDH
• Ariana Matz, MD
• Brenda Matzkin, PT
• Tian Mauer
• Maria Mauldon, APRN
• Jennifer Kathleen Maule
• Christopher Dionisio Maulion, M.D.

• Clinical Social Worker in New Haven, CT
• Providers in New Haven, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.