Provider Demographics
NPI:1609049642
Name:GHEZZI, MATTHEW (LMHC)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:GHEZZI
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1881 NE 26TH ST
Mailing Address - Street 2:STE# 70
Mailing Address - City:WILTON MANORS
Mailing Address - State:FL
Mailing Address - Zip Code:33305-1416
Mailing Address - Country:US
Mailing Address - Phone:954-317-3978
Mailing Address - Fax:954-909-4480
Practice Address - Street 1:1881 NE 26TH ST
Practice Address - Street 2:STE# 70
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33305-1416
Practice Address - Country:US
Practice Address - Phone:954-317-3978
Practice Address - Fax:954-909-4480
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6712101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health