National Provider Identifier Database

KELLY L MATTIS, L.P.C.C. – NPI #1841429719
Counselor

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master?s degree and clinical experience and supervision for licensure or certification.


Contact Information

KELLY L MATTIS, L.P.C.C.
520 3RD ST NW
JAMESTOWN, ND58401-2968
Phone: 701-253-6300
Fax: 701-253-6400
Website:
Specialty Taxonomy Code
* Counselor 101Y00000X
Mental Health 101YM0800X
Pastoral 101YP1600X

* Indicates primary specialty

NPI Profile & details for KELLY L MATTIS

NPI Number 1841429719
Credentials L.P.C.C.
Entity Individual
Enumeration date 07/13/2009
Last updated 01/29/2015 - About 11 years ago
Sole proprietor1 No
Identifiers
  • ND License #: 626-3-1-09-185
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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