MICHELLE L MATTINGLY (NPI# 1194763300) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194763300 |
| Entity Type | Individual |
| Full Name | MICHELLE L MATTINGLY |
| Credential | PHD |
| Practice Address |
3515 E Fletcher Ave Mdc 14 Tampa FL 33613-4706 |
| Mailing Address |
Po Box 917770 Orlando FL 32891-7770 |
| Practice Telephone | 8139748900 |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2016-05-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | PY7999 | FL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BLUE CROSS BLUE SHIELD | 5932P | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003474651 | Michelle Renee Mattingly | Social Worker | 312 Iowa Ave, Muscatine, IA 52761-3836 | 2019-05-30 |
| 1124495254 | Michelle Eileen Mattingly | Counselor | 1526 Republic St, Cincinnati, OH 45202-7016 | 2015-08-24 |
| 1427364876 | Michelle Melissa Mattingly | Audiologist-Hearing Aid Fitter | 150 W Half Day Rd, Suite 105, Buffalo Grove, IL 60089-6591 | 2010-08-24 |
| Street Address |
3515 E FLETCHER AVE MDC 14 |
| City | TAMPA |
| State | FL |
| Zip Code | 33613-4706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508856261 | David Newman | Physical Therapist | 3515 E Fletcher Ave, Mdc 90, Tampa, FL 33613-4706 | 2005-10-25 |
| 1932746328 | Kimberly Ann Knap | Psychologist | 3515 E Fletcher Ave, Tampa, FL 33613-4706 | 2019-12-04 |
| 1932624194 | Karie Suzanne John | Behavior Technician | 3515 E Fletcher Ave, Tampa, FL 33613-4706 | 2017-08-09 |
| 1164974366 | University Medical Service Association Inc | Assistant Behavior Analyst | 3515 E Fletcher Ave, Tampa, FL 33613-4706 | 2016-11-04 |
| 1801214002 | Grace Hyeiwon Lee | Psychiatry & Neurology | 3515 E Fletcher Ave, Tampa, FL 33613 | 2014-04-03 |
| 1528492857 | Brian E Bunnell | Psychologist | 3515 E Fletcher Ave, Tampa, FL 33613-4706 | 2013-08-22 |
| 1104168855 | Christina Mary Martin | Psychiatry & Neurology | 3515 E Fletcher Ave, Tampa, FL 33613-4706 | 2013-03-20 |
| 1467707059 | Amanda Lynn Walker | Social Worker | 3515 E Fletcher Ave, Mdc 14, Tampa, FL 33613-4702 | 2012-07-19 |
| 1043598014 | Brittany Dawn Zern | Psychologist | 3515 E Fletcher Ave, Mdc 14, Tampa, FL 33613-4702 | 2011-07-25 |
| 1861789521 | Thea Rosanna Moore | Pharmacist | 3515 E Fletcher Ave, Tampa, FL 33613-4702 | 2011-07-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649877671 | Lisandra Isabelle Raba | Behavior Technician | 3299 Usf Banyan Circle, Tampa, FL 33613 | 2020-10-02 |
| 1184250490 | Stetho Md LLC | Family Medicine | 1707 E Bearss Ave, Tampa, FL 33613 | 2020-03-18 |
| 1174187645 | Renee Pinheiro | Student in an Organized Health Care Education/Training Program | Usf Health Morsani College of Medicine, 12901 Bruce B Downs Blvd. Mdc5, Tampa, FL 33613 | 2019-04-30 |
| 1104388842 | Heartbeat Home Health Care LLC | Home Health | 13542 N Florida Ave Ste 209-b, Tampa, FL 33613 | 2019-04-02 |
| 1437625357 | Carierx LLC | Pharmacy | 15511 N. Florida Avenue, Ste 601, Tampa, FL 33613 | 2018-10-18 |
| 1205312980 | Sabina Vlaeva | Dentist | Affordable Dentures & Implants, 14936 N Florida Avenue Ste 101, Tampa, FL 33613 | 2018-07-16 |
| 1780170266 | Joy M. Alexander | Driver | 14209 Cyber Pl Apt 102, Tampa, FL 33613 | 2018-07-08 |
| 1598289829 | Lillian Perez | Social Worker | 13542 N Florida Avenue, Suite 210, Tampa, FL 33613 | 2017-07-28 |
| 1134640386 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3100 E Fletcher Ave Ste A165, Tampa, FL 33613 | 2017-06-28 |
| 1770016099 | Marcus Bruno | Physician Assistant | 13701 Bruce B Downs Blvd., Tampa, FL 33613 | 2017-04-04 |
| Find all providers in zip 33613 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922489293 | David Ritchie | Clinical Neuropsychologist | 3108 W Cypress St, Tampa, FL 33607-5108 | 2015-06-12 |
| 1114334380 | Tahirin Artreches | Clinical Neuropsychologist | 2907 W Bay To Bay Blvd Ste 340, Tampa, FL 33629-7449 | 2014-07-18 |
| 1912226655 | Erin Kimberly Bailey | Clinical Neuropsychologist | 2835 W. De Leon St., Suite 205, Tampa, FL 33609 | 2010-05-20 |
| 1144460783 | Marc A. Silva | Clinical Neuropsychologist | 13000 Bruce B Downs Blvd # 116b, James A. Haley Veterans' Hospital, Tampa, FL 33612-4745 | 2009-02-23 |
| 1417145905 | Zoe E Proctor-weber | Clinical Neuropsychologist | 13523 Capitol Dr, Tampa, FL 33613-3105 | 2007-10-09 |
| 1659562593 | Alison J Donnell | Clinical Neuropsychologist | 2909 W Bay To Bay Blvd, Suite 200, Tampa, FL 33629-8100 | 2007-08-06 |
| 1548484348 | Jeffrey Michael Merin | Clinical Neuropsychologist | 3703 W Swann Ave, Tampa, FL 33609-4521 | 2007-04-12 |
| 1295876761 | Rebecca Mcalaster | Clinical Neuropsychologist | Tampa General Hospital Rehabilitation Center, 2 Columbia Dr, Tampa, FL 33606-1289 | 2007-02-09 |
| 1124123534 | Florida Medical Psychology Associates, LLC | Clinical Neuropsychologist | 12167 W. Linebaugh Ave., Tampa, FL 33626-4615 | 2006-09-13 |
| 1902810153 | Andrea Lynn Friedman | Clinical Neuropsychologist | 12169 W Linebaugh Ave, Westchase, Tampa, FL 33626-1732 | 2006-07-27 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.