DANIELLE DESSA MATLOCK (LCSW) – Clinical Social Worker, NPI 1104233709

DANIELLE DESSA MATLOCK (LCSW) is a healthcare provider. based in Corbin, Kentucky. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 253257 (KY). The NPI Number for DANIELLE DESSA MATLOCK (LCSW) is 1104233709

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
DANIELLE DESSA MATLOCK (LCSW)
NPI
1104233709
Phone
Not provided
Address
PO BOX 568
Enumeration Date
15 July 2014
Last Update Date
3 May 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8593759200
Graduation Year
2015 (11 years ago)
PAC ID
9032473228
Group Practice PAC ID
7113262163
Professional Enrollment ID
I20180516002379
Address ID
KY400788199WI2084XSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:11State licenses:1Digital endpointsOther names

1,195 CLINICAL SOCIAL WORKER in KY

Provider Addresses for DANIELLE DESSA MATLOCK (LCSW)

  • PO BOX 568

    CORBIN, KY 407020568

    Phone:

    Type: Mailing

  • 1203 AMERICAN GREETING CARD RD

    CORBIN, KY 407014811

    Phone: (606) 528-7010

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-05-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180516002379IClinical Social WorkerKYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 40702)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7113262163View full group profile
NameSpecialtyState
Clinical Social WorkerKY
Mental Health CounselorKY
Nurse PractitionerKY
Nurse PractitionerKY
Nurse PractitionerKY
Clinical Social WorkerKY
Nurse PractitionerKY
Clinical Social WorkerKY
Clinical Social WorkerKY
Nurse PractitionerKY

Reviews

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Frequently asked questions

What is the registry number for DANIELLE DESSA MATLOCK (LCSW)?
The registry entry for DANIELLE DESSA MATLOCK (LCSW) shows NPI 1104233709.
Quick check: is DANIELLE DESSA MATLOCK (LCSW) active?
Public NPPES data shows DANIELLE DESSA MATLOCK (LCSW) with an active NPI status right now.
What does the directory say DANIELLE DESSA MATLOCK (LCSW) does?
Insurance directories may phrase it differently, but here DANIELLE DESSA MATLOCK (LCSW) maps to Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What geographic area is tied to DANIELLE DESSA MATLOCK (LCSW)?
DANIELLE DESSA MATLOCK (LCSW) is associated with Corbin, Kentucky in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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