Individual
FAITH E MATTISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, MSSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
6913123
WI
1041C0700X
Clinical Social Worker
Primary
6913-123
WI
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487686648
BCBSWI
WI
05
—
1487686648
—
WI
01
—
MATTIFAI-MO
MERCYCARE INSURANCE
WI
Enumeration date
07/07/2006
Last updated
04/29/2025
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