Active NPI
Mattilan Winter Martin Correa, LP
- Clinical Psychologist
- Waseca, MN
National Provider Identifier
1841094067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP7142
- Practice address
- 805 5TH St SW
Waseca, MN 56093-2003 - Phone
- (612) 619-6421
- NPI assigned
- Apr 4, 2025
- Last updated
- Apr 4, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP7142 | MN | Primary |
Addresses
Primary practice location
805 5TH St SW
Waseca, MN 56093-2003
Mailing address
8721 Palmgren Ave NE
Otsego, MN 55330-4402
Phone (612) 619-6421
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
| License | State | Type | Specialty |
|---|---|---|---|
| LP7142 | MN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743724800000",
"number": "1841094067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8721 PALMGREN AVE NE",
"city": "OTSEGO",
"state": "MN",
"postal_code": "553304402",
"telephone_number": "612-619-6421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 5TH ST SW",
"city": "WASECA",
"state": "MN",
"postal_code": "560932003",
"telephone_number": "612-619-6421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN CORREA",
"first_name": "MATTILAN",
"middle_name": "WINTER",
"name_prefix": "Dr.",
"credential": "LP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-04",
"last_updated": "2025-04-04",
"certification_date": "2025-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP7142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waseca, MN
- Sara Loose, LICSW
- Aaron Matthew M Ingram
- Linda Lee Maher, CMT
- Mairs Chiropractic Inc (Precision Chiropractic and Wellness)
- Ryan Jason Mairs, D.C.
- Mayo Clinic Health System
- Mayo Clinic Health System-Southwest Minnesota Region (Mayo Clinic Health System-Waseca)
- Mayo Clinic Health System-Southwest Minnesota Region (Mayo Clinic Health System-Waseca)
- Mayo Clinic Health System-Southwest Minnesota Region (Mayo Clinic Health System-Waseca)
- Mayo Clinic Health System-Southwest Minnesota Region (Mayo Clinic Health System-Waseca)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.