Provider Demographics
NPI:1700535242
Name:MATEO, ANA J (LMHC)
Entity Type:Individual
Prefix:MS
First Name:ANA
Middle Name:J
Last Name:MATEO
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 1:9940 COSTA DEL SOL BLVD
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2357
Mailing Address - Country:US
Mailing Address - Phone:786-486-2798
Mailing Address - Fax:
Practice Address - Street 1:9940 COSTA DEL SOL BLVD
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-2357
Practice Address - Country:US
Practice Address - Phone:786-486-2798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH20538101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health