NPI Profile for KELLY L MATTIS in JAMESTOWN, ND.
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.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Counselor |
101Y00000X | |||
Mental Health |
101YM0800X | |||
Pastoral |
101YP1600X |
| NPI # | 1841429719 |
|
| Status | Active | |
| Credentials | L.P.C.C. | |
| Entity | Individual | |
| Enumeration date | 07/13/2009 | |
| Last updated | 01/29/2015 - About 11 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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KELLY L MATTIS
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