Provider Demographics
NPI:1144780867
Name:MATOS, BRITTANY LAYNE (LPCC)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LAYNE
Last Name:MATOS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:LAYNE
Other - Last Name:MATOS-TOWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-3585
Mailing Address - Country:US
Mailing Address - Phone:612-225-1500
Mailing Address - Fax:
Practice Address - Street 1:201 N BROAD ST
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-3585
Practice Address - Country:US
Practice Address - Phone:507-225-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-20
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC01936101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional