Individual provider Active NPI

Sherry Stapp Mattos, LMHC

  • Professional Counselor
  • Winter Park, FL
National Provider Identifier
1023283801
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
MH7519 Issued in FL
Practice address
1299 W Fairbanks Ave Ste a
Winter Park, FL 32789-4886
Phone
(407) 821-3098
Fax
(407) 821-3097
NPI assigned
Apr 23, 2008
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X MH7519 FL Primary

Addresses

Primary practice location

1299 W Fairbanks Ave Ste a
Winter Park, FL 32789-4886

Mailing address

1299 W Fairbanks Ave Ste a
Winter Park, FL 32789-4886
Phone (407) 821-3098

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MH7519FLMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Life Journey Counseling and Consulting, LLC Professional CurrentSince Jul 24, 2022 Accepting new patients

Locations

11537 Lake Underhill Rd
Orlando, FL 32825
Phone (407) 821-3098

1299 W Fairbanks Ave
Ste A
Winter Park, FL 32789
Phone (407) 821-3098

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1023283801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1299 W FAIRBANKS AVE STE A",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894886",
            "telephone_number": "407-821-3098",
            "fax_number": "407-821-3097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1299 W FAIRBANKS AVE STE A",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894886",
            "telephone_number": "407-821-3098",
            "fax_number": "407-821-3097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTOS",
        "first_name": "SHERRY",
        "middle_name": "STAPP",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "MH7519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.