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General NPI Number Information
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NPI Number | 1881552669
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Entity Type | Individual
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Provider Name | MR. MICHAEL MATTSON
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Gender | Male
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 227 NW SCHOOL ST
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City | ANKENY
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State | IA
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Zip | 50023-1746
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Country | US
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Telephone | 515-964-5003
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Fax | 515-964-3856
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Provider Business Mailing Address
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Address Line | 302 KNOTTS ST
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City | NEW VIRGINIA
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State | IA
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Zip | 50210-7750
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Country | US
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Telephone | 641-373-0749
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | IA
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