Provider Demographics
NPI:1023283801
Name:MATTOS, SHERRY STAPP (LMHC)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:STAPP
Last Name:MATTOS
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 1:1299 W FAIRBANKS AVE STE A
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4886
Mailing Address - Country:US
Mailing Address - Phone:407-821-3098
Mailing Address - Fax:407-821-3097
Practice Address - Street 1:1299 W FAIRBANKS AVE STE A
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4886
Practice Address - Country:US
Practice Address - Phone:407-821-3098
Practice Address - Fax:407-821-3097
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7519101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional