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General NPI Number Information
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NPI Number | 1447946231
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Entity Type | Individual
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Provider Name | KAREN PATRICIA MATTERN LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/13/2023
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Last Update Date | 06/05/2023
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Provider Practice Location Address
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Address Line | 2770 INDIAN RIVER BLVD STE 314-315
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City | VERO BEACH
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State | FL
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Zip | 32960-4299
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Country | US
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Telephone | 772-569-0716
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Fax | 772-569-9303
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Provider Business Mailing Address
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Address Line | 1090 W 13TH SQ
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City | VERO BEACH
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State | FL
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Zip | 32960-2116
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Country | US
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Telephone | 772-633-1530
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW-12798
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License Number State | FL
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