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NPI Code Detail

MEDICARE: HEATHER MATSON LMFT, ATR-BC

MEDICARE: HEATHER MATSON LMFT, ATR-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1221700000XArt Therapist14096MN
2106H00000XMarriage & Family Therapist2877MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154717429
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER MATSON LMFT, ATR-BC
Provider Business Mailing Address
First Line : 275 4TH ST E STE 301
Second Line :
City : SAINT PAUL
State : MN
Zip : 55101-1771
Country : US
Telephone Number : 651-318-0109
Fax Number : 651-344-0515
Provider Business Practice Location Address
First Line : 275 4TH ST E STE 301
Second Line :
City : SAINT PAUL
State : MN
Zip : 55101-1771
Country : US
Telephone Number : 651-318-0109
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2015
Last Update Date : 05/08/2018

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Directions to “ HEATHER MATSON LMFT, ATR-BC” Practice Location

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