Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

William Mattingly

Individual provider Professional Counselor · NPI 1407352115

William Mattingly is a Mental Health Counselor in Kirkwood, Missouri. Qualified in 2017, 9 years ago. Licensed in Missouri.

Years since qualifying
9
Licensed in
MO
In the registry since
2018

Practice location Address checks out

12166 Old Big Bend Rd Ste 204
Kirkwood, MO 63122-6836
Phone: (314) 822-8888
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 2017041348 (MO)

Record details

NPI number1407352115
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 2, 2018
Last updated in NPPESFebruary 21, 2022
Certification dateFebruary 21, 2022
Mailing address12166 Old Big Bend Rd Ste 204, Kirkwood, MO 63122-6836

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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