Individual
MS. KELLY L. MATTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.C.C.
Contact information
Practice address
520 3RD ST NW, JAMESTOWN, ND 58401-2968
(701) 253-6300
(701) 253-6400
Mailing address
PO BOX 2055, JAMESTOWN, ND 58402-2055
(701) 253-6300
(701) 253-6400
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
626-3-1-09-185
ND
101YM0800X
Mental Health Counselor
626-3-1-09-185
ND
101YP1600X
Pastoral Counselor
626-3-1-09-185
ND
Other
Enumeration date
07/13/2009
Last updated
01/29/2015
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