Provider Demographics
NPI:1487706933
Name:MATTSON, ARTHUR J (MSW)
Entity type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:J
Last Name:MATTSON
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:571 LEAHY ST
Mailing Address - Street 2:
Mailing Address - City:MANTENO
Mailing Address - State:IL
Mailing Address - Zip Code:60950-1015
Mailing Address - Country:US
Mailing Address - Phone:815-258-4910
Mailing Address - Fax:
Practice Address - Street 1:571 LEAHY ST
Practice Address - Street 2:
Practice Address - City:MANTENO
Practice Address - State:IL
Practice Address - Zip Code:60950-1015
Practice Address - Country:US
Practice Address - Phone:815-258-4910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149007211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical