Active NPI
Emily Ann McKenna-Mattson, PH.D.
- Behavior Analyst
- Ardmore, PA
National Provider Identifier
1992034417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 760 Humphreys Rd
Ardmore, PA 19003-2038 - Phone
- (610) 658-2345
- NPI assigned
- Dec 11, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary | ||
| School Psychologist | 103TS0200X |
Addresses
Primary practice location
760 Humphreys Rd
Ardmore, PA 19003-2038
Mailing address
760 Humphreys Rd
Ardmore, PA 19003-2038
Phone (610) 658-2345
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gibson Community Hospital Association | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260489600000",
"number": "1992034417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "760 HUMPHREYS RD",
"city": "ARDMORE",
"state": "PA",
"postal_code": "190032038",
"telephone_number": "610-658-2345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "760 HUMPHREYS RD",
"city": "ARDMORE",
"state": "PA",
"postal_code": "190032038",
"telephone_number": "610-658-2345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKENNA-MATTSON",
"first_name": "EMILY",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-12-11",
"last_updated": "2009-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ardmore, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.