JESSICA KATHLEEN MATTINGLY (NPI# 1679706113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679706113 |
| Entity Type | Individual |
| Full Name | JESSICA KATHLEEN MATTINGLY |
| Other Name | JESSICA KATHLEEN BONATAKIS |
| Credential | PSY.D. |
| Practice Address |
22 Northeast Dr Hershey PA 17033-2732 |
| Mailing Address |
Po Box 858 Mc A410 Hershey PA 17033-0858 |
| Practice Telephone | 7175318338 |
| Practice Fax Number | 7175316250 |
| Mailing Telephone | 8002431455 |
| Enumeration Date | 2009-09-01 |
| Last Update Date | 2019-08-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
129694 | KY | Behavioral Health & Social Service Providers |
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
PS018803 | PA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 500 University Dr, Hershey, PA 170332360 | 8002431455 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497010482 | Jessica Kae Mattingly | Speech-Language Pathologist | 9000 Las Vegas Blvd S Unit 2035, Las Vegas, NV 89123-6406 | 2012-07-06 |
| 1093373771 | Jessica Mattingly | Registered Nurse | 340 Nw Commerce Dr, Lake City, FL 32055-4709 | 2019-05-29 |
| 1134664949 | Jessica Ann Mattingly | Nurse Practitioner | 170 Dr Arla Way, Louisville, KY 40229 | 2017-01-03 |
| 1255874731 | Jessica Nicole Mattingly | Nurse Practitioner | 7926 Preston Hwy Ste 106, Louisville, KY 40219-3848 | 2016-12-01 |
| 1891192324 | Jessica Mattingly | Social Worker | 900 Beasley St, Lexington, KY 40509-4266 | 2014-11-26 |
| Street Address |
22 NORTHEAST DR |
| City | HERSHEY |
| State | PA |
| Zip Code | 17033-2732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700835477 | Lidija Petrovic-dovat | Psychiatry & Neurology | 22 Northeast Dr, Hershey, PA 17033-2732 | 2006-05-09 |
| 1275091829 | Michael Thomas Decristofaro | Marriage & Family Therapist | 22 Northeast Dr, Hershey, PA 17033-2732 | 2019-03-03 |
| 1265948079 | Jesse R Northridge | Social Worker | 22 Northeast Dr, Hershey, PA 17033-2732 | 2017-12-18 |
| 1184140303 | Marci J Houck | Social Worker | 22 Northeast Dr, Hershey, PA 17033-2732 | 2017-08-18 |
| 1356871644 | Autumn Joy Kujawa | Psychologist | 22 Northeast Dr, Hershey, PA 17033-2732 | 2017-06-19 |
| 1417484833 | Dahlia Mukherjee | Psychologist | 22 Northeast Dr, Hershey, PA 17033-2732 | 2017-05-16 |
| 1447786421 | Mohammad Ali Humza Salim | Student in an Organized Health Care Education/Training Program | 22 Northeast Dr, Hershey, PA 17033-2732 | 2017-05-11 |
| 1336673599 | Sierra L Brown | Psychologist | 22 Northeast Dr, Hershey, PA 17033-2732 | 2017-04-14 |
| 1508317082 | Stephanie F Harvison | Counselor | 22 Northeast Dr, Hershey, PA 17033-2732 | 2016-10-19 |
| 1487006144 | Chelsea Kay Belles | Social Worker | 22 Northeast Dr, Hershey, PA 17033-2732 | 2016-07-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891264578 | Sherpa Sleep Solutions LLC | Durable Medical Equipment & Medical Supplies | 20 Briarcrest Square, Suite 207, Hershey, PA 17033 | 2018-11-25 |
| 1366933186 | Benjamin Abney | General Practice | Hershey Medical Center, 500 University Drive, Hershey, PA 17033 | 2018-05-29 |
| 1174014062 | Sean Nutting | Student in an Organized Health Care Education/Training Program | 500 University Dr Dept Of, Hershey, PA 17033 | 2018-05-25 |
| 1447751144 | Elizabeth Ashley Lohman | Specialist/Technologist | 665 Brook Drive, Hershey, PA 17033 | 2018-02-27 |
| 1376056382 | Yilmarie Mercado Vargas | Student in an Organized Health Care Education/Training Program | Penn State Health Milton Hershey Medical Center, 500 University Dr, Hershey, PA 17033 | 2017-11-13 |
| 1730603440 | Aleksandr Sviatchenko | Student in an Organized Health Care Education/Training Program | Penn State Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, Pa, PA 17033 | 2017-08-03 |
| 1598293979 | Andrea Rae Hiller | Plastic Surgery | 500 University Dr # Mch071, Hershey, PA 17033 | 2017-05-30 |
| 1649706649 | Natalia Katarzyna Pierwola-gawin | Physical Therapist | 500 University Dr. Mc A410, Hershey, PA 17033 | 2017-05-11 |
| 1205380854 | Joseph Soon Park | Student in an Organized Health Care Education/Training Program | 200 Campus Drive, Suite 3100, Hershey, PA 17033 | 2016-08-12 |
| 1437505096 | Lynnlee Christine Depicolzuane | Pediatrics | 600 University Drive, Hershey, PA 17033 | 2016-05-12 |
| Find all providers in zip 17033 | ||||
| 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 |
|---|---|---|---|---|
| 1649600586 | Dara Babinski | Psychologist | 500 University Dr # C5627, Department of Psychiatry, H073, Hershey, PA 17033-2360 | 2013-11-13 |
| 1609429299 | Alana M Mcneill | Psychologist | 905 W Governor Rd Ste 200, Hershey, PA 17033-2310 | 2019-07-23 |
| 1356871644 | Autumn Joy Kujawa | Psychologist | 22 Northeast Dr, Hershey, PA 17033-2732 | 2017-06-19 |
| 1346670296 | Susan Minnick | Psychologist | 22 Northeast Dr, Hershey, PA 17033-2732 | 2013-11-13 |
| 1528374972 | Craig David Digiovanni | Psychologist | 500 University Dr, Hershey, PA 17033-2360 | 2010-08-24 |
| 1649340647 | Antolin M Llorente | Psychologist | 500 University Dr, Hershey, PA 17033-2360 | 2006-11-08 |
| 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 |
| 1326512005 | Lydia Brill | Psychologist | 480 Pierce St Ste 109, Kingston, PA 18704-5512 | 2019-01-16 |
| 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 |
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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.