Individual
JEROME L MATTERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, LMHC,CRC,CCM
Contact information
Practice address
3660 ROME DR, LAFAYETTE, IN 47905-4488
(765) 742-1816
(765) 742-2257
Mailing address
3660 ROME DR, LAFAYETTE, IN 47905-4488
(765) 742-1816
(765) 742-2257
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
39000332A
IN
1041C0700X
Clinical Social Worker
Primary
34003823A
IN
Other
Enumeration date
09/27/2006
Last updated
01/10/2011
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