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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 Specialty Code Provider Type

Counselor

101Y00000X
 

Mental Health

101YM0800X
 

Pastoral

101YP1600X
Indicates primary specialty

NPI Profile & details for KELLY L MATTIS · (Female)

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
  • ND License # 626-3-1-09-185
Hospital affiliation(s) Not Available
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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