Provider Demographics
NPI:1447946231
Name:MATTERN, KAREN PATRICIA (LCSW)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:PATRICIA
Last Name:MATTERN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 W 13TH SQ
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-2116
Mailing Address - Country:US
Mailing Address - Phone:772-633-1530
Mailing Address - Fax:
Practice Address - Street 1:2770 INDIAN RIVER BLVD STE 314-315
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4299
Practice Address - Country:US
Practice Address - Phone:772-569-0716
Practice Address - Fax:772-569-9303
Is Sole Proprietor?:No
Enumeration Date:2023-04-13
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW-127981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical