Matthew Keith Sissons, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3929 Issued in MN

Practice address

11 2ND St SW
Wadena, MN 56482-1482

Phone

(320) 639-2025

NPI assigned

Jan 23, 2019

Last updated

Dec 13, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northern Pines Mental Health Center IncGroup PAC ID 8628979697, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northern Pines Mental Health Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Little Falls, MN
  • NPI 1013904051
  Medicare reassignment Care Compare group NPD
• Neighborhood Counseling Center of Wadena, Inc.

  • Mental Health Counselor
  • Wadena, MN
  • NPI 1578582565
  NPD (past)
• Northern Pines Mental Health Center, Inc.

  • Community/Behavioral Health Agency
  • Brainerd, MN
  • NPI 1225168602
  NPD (past)

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1710441829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 367",
            "city": "LITTLE FALLS",
            "state": "MN",
            "postal_code": "563450367",
            "telephone_number": "320-639-2025",
            "fax_number": "320-200-7527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 2ND ST SW",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "564821482",
            "telephone_number": "320-639-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISSONS",
        "first_name": "MATTHEW",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-23",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "IMH17584",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "MH21911",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "3929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Selvey, MD
• Shari Phillips LLC (Imagine Mental Health Counseling)
• April Marie Shone
• Shoptikal LLC (Shopko Optical 4281)
• Julie Anne Sibert
• Kaitlyn Rose Skow, PHARMD
• Molly Slaby
• Timothy S Sly, P.T.
• Michelle Joy Small, BS
• Rachael Lynn Spear, CRNA

• Mental Health Counselor in Wadena, MN
• Providers in Wadena, 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 Dec 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.