Donald C. Mattson, PHD, ATR, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

5340-125 Issued in WI

Practice address

3215 Tower Ave
Ste. 108
Superior, WI 54880-5388

Phone

(715) 718-5606

NPI assigned

Jun 13, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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

• The Creative Counseling Group

  • Mental Health Counselor
  • Superior, WI
  • NPI 1114302684
  NPD (past) Authorized official

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443139200000",
    "number": "1770878282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3215 TOWER AVE.",
            "address_2": "STE. 108",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548805269",
            "telephone_number": "715-718-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 TOWER AVE",
            "address_2": "STE. 108",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548805388",
            "telephone_number": "715-718-5606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTSON",
        "first_name": "DONALD",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "PHD, ATR, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-13",
        "last_updated": "2015-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401012474",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "5340-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780697078",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Loretta Maciosek
• Emily Rose Mack, MSW
• Amanda Maderich, PHARMD
• Ashley Madill
• Jennifer Kay Martin, PTA
• Katherine Jean McCall
• Maurice McClain
• Taylor Marie McClung, MSW, LICSW, LCSW
• Cheryl L McDonald, RN
• Ellen Jane McDonald

• Mental Health Counselor in Superior, WI
• Providers in Superior, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; 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.