Provider Demographics
NPI:1811666001
Name:YOU MATTER COUNSELING SERVICES, INC
Entity type:Organization
Organization Name:YOU MATTER COUNSELING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MA, LMHC
Authorized Official - Phone:321-614-1704
Mailing Address - Street 1:905 E NEW HAVEN AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-5477
Mailing Address - Country:US
Mailing Address - Phone:321-676-8731
Mailing Address - Fax:321-241-3098
Practice Address - Street 1:905 E NEW HAVEN AVE STE 203
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-5477
Practice Address - Country:US
Practice Address - Phone:321-676-8731
Practice Address - Fax:321-241-3098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
14954983OtherCAQH
1942819024OtherINDIVIDUAL NPI
FLMH18237OtherLICENSURE