Healthcare Provider Details

I. General information

NPI: 1255016564
Provider Name (Legal Business Name): HEIDI M M MATHSON LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEIDI M MEYER LGSW

II. Dates (important events)

Enumeration Date: 06/15/2023
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 FRANKLIN ST
WINONA MN
55987-3822
US

IV. Provider business mailing address

103 WINONA ST SE
CHATFIELD MN
55923-1815
US

V. Phone/Fax

Practice location:
  • Phone: 507-453-9563
  • Fax:
Mailing address:
  • Phone: 507-951-6948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number134303-121
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number32163
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: