Provider Demographics
NPI:1457651804
Name:MATTHEWS, JESSICA S (MS)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:S
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10499 FGCU BLVD S
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33965-0001
Mailing Address - Country:US
Mailing Address - Phone:239-745-4614
Mailing Address - Fax:
Practice Address - Street 1:10499 FGCU BLVD S
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33965-4610
Practice Address - Country:US
Practice Address - Phone:239-745-4614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health