Rae Lynne Mattis is a Clinical in Lilburn, Georgia. Rae Lynne Mattis practices all healthcare services and medical treatments related to Clinical. The NPI Number for Rae Lynne Mattis is 1518170315. The last update date is 2007-07-08.
Rae Lynne Mattis's current location address is 296 Ecarte Court, Lilburn, Georgia. You can contact this provider via phone number 7709629597 and fax number 7702797588. The mailing address for Rae Lynne Mattis is 296 Ecarte Court, Lilburn, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Rae Lynne Mattis |
|---|---|
| Address | 296 Ecarte Court, Lilburn, Georgia |
| Phone Number | 7709629597 |
| Fax Number | 7702797588 |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1518170315 |
|---|---|
| Provider Enumeration Date | 2007-05-08 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 296 Ecarte Court |
|---|---|
| City | Lilburn |
| State | Georgia (GA) |
| Post Code | 300476412 |
| Phone Number | 7709629597 |
| Fax Number | 7702797588 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | CSW 001809 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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What is the unique 10-digit identifier code assigned to Rae Lynne Mattis by the Centers for Medicare & Medicaid Services?
The Rae Lynne Mattis has been issued the NPI (National Provider Identifier) 1518170315 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you share the physical location details of Rae Lynne Mattis?
The Rae Lynne Mattis is situated at 296 Ecarte Court, in the city of Lilburn, state of GA, with the zip code 300476412.
What is Rae Lynne Mattis's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Rae Lynne Mattis is Clinical, and the taxonomy code that categorizes this field of expertise is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services issue the 1518170315 to Rae Lynne Mattis?
The Rae Lynne Mattis received its 1518170315 assignment from the Centers for Medicare & Medicaid Services on 2007-05-08.
When was the information regarding Rae Lynne Mattis, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Rae Lynne Mattis, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2007-07-08.
NPI Number: 1912900226
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