Individual provider Active NPI

Brittany Layne Matos, LPCC

  • Professional Counselor
  • Mankato, MN
National Provider Identifier
1144780867
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CC01936 Issued in MN
Practice address
201 N Broad St
Mankato, MN 56001-3585
Phone
(507) 225-1500
NPI assigned
Mar 20, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CC01936 MN Primary

Addresses

Primary practice location

201 N Broad St
Mankato, MN 56001-3585

Mailing address

201 N Broad St
Mankato, MN 56001-3585
Phone (612) 225-1500

Other names 1

  • Brittany Layne Matos-Town Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bgomez-matos@nystromcounseling.com Direct Nystrom & Associates

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CC01936MNMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1144780867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N BROAD ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560013585",
            "telephone_number": "612-225-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N BROAD ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560013585",
            "telephone_number": "507-225-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOS",
        "first_name": "BRITTANY",
        "middle_name": "LAYNE",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2021-04-14",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC01936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bgomez-matos@nystromcounseling.com",
            "affiliation": "Y",
            "endpointDescription": "Work email address",
            "affiliationName": "Nystrom & Associates",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "201 N Broad St",
            "city": "Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560013585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BRITTANY",
            "last_name": "MATOS-TOWN",
            "middle_name": "LAYNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.