Provider Demographics
NPI:1043743511
Name:HEATHER MATURO COUNSELING
Entity Type:Organization
Organization Name:HEATHER MATURO COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:MATURO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-508-2465
Mailing Address - Street 1:7901 4TH ST N
Mailing Address - Street 2:SUITE 322
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-4305
Mailing Address - Country:US
Mailing Address - Phone:219-508-2465
Mailing Address - Fax:
Practice Address - Street 1:7901 4TH ST N
Practice Address - Street 2:SUITE 322
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-4305
Practice Address - Country:US
Practice Address - Phone:219-508-2465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 12745251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health