Provider Demographics
NPI:1083319206
Name:MATTESON, SARAH (LMSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MATTESON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1613 CHICKADEE DR
Mailing Address - Street 2:
Mailing Address - City:ARGYLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-3444
Mailing Address - Country:US
Mailing Address - Phone:940-465-9749
Mailing Address - Fax:
Practice Address - Street 1:1613 CHICKADEE DR
Practice Address - Street 2:
Practice Address - City:ARGYLE
Practice Address - State:TX
Practice Address - Zip Code:76226-3444
Practice Address - Country:US
Practice Address - Phone:940-465-9749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55915104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker