Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mary G Mattison-Wynn, PSYDLP

Individual provider Clinical Psychologist · NPI 1649202755

Mary G Mattison-Wynn, PSYDLP is a Clinical Psychologist in Buffalo, Minnesota. Qualified in 2000, 26 years ago. Accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
26
Licensed in
MN
In the registry since
2006
Specialties on file
3

Practice location Address checks out

30 1st Ave NE # 12
Buffalo, MN 55313-1515
Phone: (612) 670-8918
Fax: (952) 300-8194
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence LP4961 (MN)
Clinical Psychologist Taxonomy 103TC0700X · Licence 4961 (MN)
Psychologist Taxonomy 103T00000X

Record details

NPI number1649202755
Entity typeIndividual (Type 1)
GenderFemale
Credentials PSYDLP
Sole proprietorNo
NPI enumeratedJuly 7, 2006
Last updated in NPPESSeptember 30, 2024
Certification dateSeptember 30, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services