Kelly Matson, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC00970 Issued in MN

Practice address

510 N Chestnut St
Suite 201
Chaska, MN 55318-3300

Phone

(952) 361-3360

Fax

(952) 513-7968

NPI assigned

Apr 13, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1265828685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 WAYZATA BLVD",
            "address_2": "SUITE",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554261343",
            "telephone_number": "763-544-1006",
            "fax_number": "763-544-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 N CHESTNUT ST",
            "address_2": "SUITE 201",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553183300",
            "telephone_number": "952-361-3360",
            "fax_number": "952-513-7968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSON",
        "first_name": "KELLY",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-13",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC00970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• James L Mayerle
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• Thomas Alan McLarnan, MSW, LICSW

• Mental Health Counselor in Chaska, MN
• Providers in Chaska, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; 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.