Active NPI
Matt Fernandez, RMHI, MA
- Mental Health Counselor
- Winter Park, FL
National Provider Identifier
1215633532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- IMH23616
- Practice address
- 1908 Howell Branch Rd
Winter Park, FL 32792-1009 - Phone
- (407) 657-8555
- NPI assigned
- Feb 7, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IMH23616 | FL | Primary |
Addresses
Primary practice location
1908 Howell Branch Rd
Winter Park, FL 32792-1009
Mailing address
1908 Howell Branch Rd
Winter Park, FL 32792-1009
Phone (407) 657-8555
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| IMH23616 | Other | FL | NON-MEDICAID PROVIDER |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMH23616 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675728000000",
"number": "1215633532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1908 HOWELL BRANCH RD",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327921009",
"telephone_number": "407-657-8555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1908 HOWELL BRANCH RD",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327921009",
"telephone_number": "407-657-8555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "MATT",
"credential": "RMHI, MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-02-07",
"last_updated": "2023-02-07",
"certification_date": "2023-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "IMH23616",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NON-MEDICAID PROVIDER",
"identifier": "IMH23616",
"state": "FL"
}
],
"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 Feb 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.