Individual
BETHANY JEAN MATTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
4027 COUNTY ROAD 25, ST LOUIS PARK, MN 55416
(612) 925-6033
(612) 925-8496
Mailing address
4240 PARK GLEN RD, ST LOUIS PARK, MN 55416-5427
(612) 925-6033
(612) 925-8496
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
15605
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
719140000
—
MN
Enumeration date
05/01/2007
Last updated
11/05/2018
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