Provider Demographics
NPI:1053956904
Name:MATTIUZ, KRISTEN M (QMHS, CCA)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:M
Last Name:MATTIUZ
Suffix:
Gender:F
Credentials:QMHS, CCA
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:HAYWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24 PALMER AVE
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-1414
Mailing Address - Country:US
Mailing Address - Phone:440-527-4605
Mailing Address - Fax:
Practice Address - Street 1:24 PALMER AVE
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-1414
Practice Address - Country:US
Practice Address - Phone:440-527-4605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-14
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator