DR. KELLY M GUSTAVSON-MATTEK PSY.D.
NPI 1750471314
Psychologist in Elkhorn, WI

Active since October 13, 2006PECOS Enrolled
1910 COUNTY ROAD NN, ELKHORN, WI 53121(262) 741-3200(262) 741-3217 Get Directions Write a Review

NPPES record last updated: May 5, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 5, 2025, Aug 28, 2023, Mar 13, 2023 (3 updates tracked since 2023).

About Dr. Kelly M Gustavson-mattek Psy.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KELLY M GUSTAVSON-MATTEK PSY.D. (NPI 1750471314) is an individual psychologist in Elkhorn, Wisconsin, licensed in Wisconsin (2533-057) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in Muskego.

NPPES Registry Identity

NPI1750471314
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. KELLY M GUSTAVSON-MATTEKCredential: PSY.D.
Location Address1910 COUNTY ROAD NNElkhorn, WI 53121-4454
Mailing AddressPo Box 1005Elkhorn, WI 53121-1005 · (262) 741-3200 · Fax (262) 741-3217
Fax(262) 741-3217
Sole ProprietorNo
Enumeration DateOctober 13, 2006
Last NPPES UpdateMay 5, 20253 updates tracked since enumeration
NPPES CertifiedMay 5, 2025
NPI 1750471314 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in WI · 2533-057
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
1910 COUNTY ROAD NN, Elkhorn, WI 53121

Other Names 1

Former Name (1)Kelly M Gustavson

Secondary Practice Location 1

Location 1W206S7867 Pasadena DrMuskego, WI 53150-9532 · Phone (262) 971-5015 · Fax (855) 210-7399

Other Identifiers 1

Medicaid40938700WI

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Kelly M Gustavson-mattek Psy.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Addiction (Substance Use Disorder))
1910 COUNTY ROAD NN
ELKHORN, WI 53121
Community/Behavioral Health
1910 COUNTY ROAD NN
ELKHORN, WI 53121
Social Worker (Clinical)
1910 COUNTY ROAD NN
ELKHORN, WI 53121
Nurse Practitioner
1910 COUNTY ROAD NN
ELKHORN, WI 53121
Public Health or Welfare
1910 COUNTY ROAD NN
ELKHORN, WI 53121
Case Management
1910 COUNTY ROAD NN
ELKHORN, WI 53121
Counselor
1910 COUNTY ROAD NN
ELKHORN, WI 53121
Social Worker (Clinical)
1910 COUNTY ROAD NN
ELKHORN, WI 53121

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Gustavson-mattek's NPI number?

The NPI number for Kelly Gustavson-mattek is 1750471314. It was assigned to this individual provider in the NPPES registry on October 13, 2006. The provider is also known as Kelly M Gustavson.

Where is Kelly Gustavson-mattek located?

Kelly Gustavson-mattek practices at 1910 County Road Nn, Elkhorn, WI 53121. The listed phone number is (262) 741-3200.

What is Kelly Gustavson-mattek's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Kelly Gustavson-mattek enrolled in Medicare?

Yes. Kelly Gustavson-mattek is registered in the Medicare PECOS enrollment system.

What insurance does Kelly Gustavson-mattek accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), Medica, Quartz and UnitedHealthcare list Kelly Gustavson-mattek as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kelly Gustavson-mattek was last updated on May 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.