MICHELE MATTIE, PHD, LLC (NPI# 1477655314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477655314 |
| Entity Type | Organization |
| Organization Name | MICHELE MATTIE, PHD, LLC |
| Practice Address |
517 Pierce St Suite B Kingston PA 18704-5731 |
| Practice Telephone | 5707181150 |
| Practice Fax Number | 5707141321 |
| Mailing Telephone | 5707181150 |
| Mailing Fax Number | 5707141321 |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. MICHELE MATTIE (OWNER) |
| Authorized Official Telephone | 5707181150 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
PS008609L | PA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | INDIVIDUAL NPI | 1285665075 | 01 |
| PA | BLUE SHIELD | 359151 | 01 |
| Street Address |
517 PIERCE ST SUITE B |
| City | KINGSTON |
| State | PA |
| Zip Code | 18704-5731 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215921572 | Lori Ann Alesson Rn | Social Worker | 517 Pierce St, Suite B, Kingston, PA 18704-5731 | 2005-09-01 |
| 1184225948 | Farook K Shroff Md | Internal Medicine | 517 Pierce St, Kingston, PA 18704-5756 | 2020-11-06 |
| 1710487764 | Sanjeev Garg LLC | Psychiatry & Neurology | 517 Pierce St, Kingston, PA 18704-5756 | 2018-02-16 |
| 1396043964 | Frank A Berman, Dds, PC | Durable Medical Equipment & Medical Supplies | 517 Pierce St, Kingston, PA 18704-5756 | 2011-03-07 |
| 1164543112 | Jeanne A Rinehouse Md P C | Psychiatry & Neurology | 517 Pierce St, Kingston, PA 18704-5731 | 2007-04-03 |
| 1851474431 | Vascular Access Center of Kingston LLC | Internal Medicine | 517 Pierce St, Kingston, PA 18704-5731 | 2006-10-24 |
| 1568494813 | Frank A Berman | Dentist | 517 Pierce St, Pierce Plaza Suite 5, Kingston, PA 18704-5731 | 2006-07-07 |
| 1285665075 | Michele Mattie | Psychologist | 517 Pierce St, Suite B, Kingston, PA 18704-5731 | 2006-07-06 |
| 1790728574 | Sanjeev Garg | Psychiatry & Neurology | 517 Pierce St, Kingston, PA 18704-5756 | 2006-06-13 |
| 1265406326 | Jeanne Ann Rinehouse | Psychiatry & Neurology | 517 Pierce St, Suite B, Kingston, PA 18704-5731 | 2006-02-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013557552 | Millmark Health Inc. | Psychiatry & Neurology | 511 Pierce Street, Kingston, PA 18704 | 2020-01-13 |
| 1427550334 | Michael Anthony Waltich | Military Health Care Provider | 82 Cooper Street, Pringle, PA 18704 | 2018-03-06 |
| 1376088435 | Jae LLC | Massage Therapist | 512 Northhampton Street, Edwardsville, PA 18704 | 2016-12-28 |
| 1306278288 | Mohammad Khaled Tashkandi | Internal Medicine | 490 Northampton St Ste 1, Edwardsville, PA 18704 | 2013-08-02 |
| 1396180014 | Sammie Craven IIi | Pharmacist | 96 1st Avenue, Kingston, PA 18704 | 2013-05-08 |
| 1447693114 | Catherine Mary Harding | Nurse Practitioner | 141 South Maple Ave, Kingston, PA 18704 | 2013-04-12 |
| 1861781403 | Jennifer Ann Richards | Pharmacist | 22 West Side Mall, Edwardsville, PA 18704 | 2011-04-05 |
| 1558512772 | Jolon Theresa Sherin | Speech-Language Pathologist | 1825 Sans Souci Highway, Hanover, PA 18704 | 2008-10-07 |
| 1932361102 | Kari Ann Pietralczyk | Audiologist | 190 Welles Street, Forty-fort, PA 18704 | 2008-06-30 |
| 1467584151 | John Christopher Storti | Chiropractor | 180 United Penn Plaza, Kingston, PA 18704 | 2007-03-09 |
| Find all providers in zip 18704 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326512005 | Lydia Brill | Psychologist | 480 Pierce St Ste 109, Kingston, PA 18704-5512 | 2019-01-16 |
| 1699715110 | Brooke Egbert | Psychologist | 270 Pierce St Ste 301, Kingston, PA 18704-5141 | 2006-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629615810 | Ganim Psychology and Behavioral Health, Pllc | Psychologist | 80 West Welsh Pool Road, Suite 204 South, Exton, PA 19341-1233 | 2019-12-06 |
| 1164067450 | Whitney Guthrie | Psychologist | 2716 South St Ofc 5241, Philadelphia, PA 19146-2305 | 2019-11-11 |
| 1205470176 | Thomas Anderson Smith | Psychologist | 491 Allendale Rd Ste 320, King of Prussia, PA 19406-1432 | 2019-11-04 |
| 1841849460 | Colleen Mary Harker | Psychologist | 1518 Walnut St Ste 1506, Philadelphia, PA 19102-3408 | 2019-09-06 |
| 1548815814 | Estee Hausman | Psychologist | 337 Moore Bldg, State College, PA 16802-3103 | 2019-08-05 |
| 1689151318 | Stacey Linn Brookens | Psychologist | 77 N 3rd St Ste 201, Chambersburg, PA 17201-1812 | 2018-07-25 |
| 1144710039 | Pamela Marie Cole | Psychologist | 3rd Floor, Moore Building, Penn State University, University Park, PA 16802 | 2018-05-16 |
| 1326536749 | Rebecca Kanine | Psychologist | 2716 South St Fl 8, Philadelphia, PA 19146-2305 | 2018-05-01 |
| 1275048654 | Dominic J. Deluigi Phd LLC | Psychologist | 500 Market St., Sutei 204b, Beaver, PA 15009 | 2017-12-07 |
| 1346768074 | Johanna Rich Tesman | Psychologist | 1200 Walnut Bottom Rd Ste 311, Carlisle, PA 17015-7766 | 2017-09-01 |
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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.