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NPI Code Detail

MEDICARE: CHRISTINE MATTINGLY-JONES LMFT

MEDICARE: CHRISTINE MATTINGLY-JONES LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist3697MN
2106H00000XMarriage & Family Therapist2539TN
3106H00000XMarriage & Family Therapist2159WI
4390200000XStudent in an Organized Health Care Education/Training Program
5106H00000XMarriage & Family Therapist15695AZ

General Provider Information

NPI Number : 1588199848
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE MATTINGLY-JONES LMFT
Provider Business Mailing Address
First Line : 34700 VALLEY RD
Second Line :
City : OCONOMOWOC
State : WI
Zip : 53066-4500
Country : US
Telephone Number : 262-646-4411
Fax Number :
Provider Business Practice Location Address
First Line : 2424 S 102ND ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53227-2106
Country : US
Telephone Number : 262-646-4411
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2017
Last Update Date : 08/13/2025

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