Provider Demographics
NPI:1558041335
Name:MATTERN COUNSELING, LLC
Entity Type:Organization
Organization Name:MATTERN COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:MATTERN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:772-633-1530
Mailing Address - Street 1:2770 INDIAN RIVER BLVD STE 314-15
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4299
Mailing Address - Country:US
Mailing Address - Phone:772-617-2276
Mailing Address - Fax:772-569-9303
Practice Address - Street 1:2770 INDIAN RIVER BLVD STE 314-15
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4299
Practice Address - Country:US
Practice Address - Phone:772-617-2276
Practice Address - Fax:772-569-9303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty