Provider Demographics
NPI:1629619408
Name:MATEU, ANNETTE (LMHC)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:MATEU
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9628 NE 2ND AVE STE 210E
Mailing Address - Street 2:
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-2748
Mailing Address - Country:US
Mailing Address - Phone:305-298-7272
Mailing Address - Fax:
Practice Address - Street 1:9628 NE 2ND AVE STE 210E
Practice Address - Street 2:
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138-2748
Practice Address - Country:US
Practice Address - Phone:786-281-3935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-03
Last Update Date:2019-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16942101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty