Modern Mental Health LLC

Primary specialty

Group Psychotherapy PsychologistTaxonomy code 103TP2701X

Legal business name

MODERN MENTAL HEALTH LLC

Practice address

3000 Gulf to Bay Blvd Ste 312
Clearwater, FL 33759-4304

Phone

(727) 279-0101

NPI assigned

Jul 2, 2020

Last updated

Jul 2, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jaclyn Matthews, LMHCNPI 1184160590

Title

Owner

Phone

(848) 299-9329

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jaclyn Matthews, LMHC

  • Mental Health Counselor
  • Clearwater, FL
  • NPI 1184160590
  NPD Authorized official

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

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593648000000",
    "number": "1487271763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 34TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337041842",
            "telephone_number": "848-299-9329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 GULF TO BAY BLVD STE 312",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337594304",
            "telephone_number": "727-279-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-02",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A",
        "authorized_official_last_name": "MATTHEWS",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "848-299-9329",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Felix T. Molas, CRNA

• Group Psychotherapy Psychologist in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Group Psychotherapy Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; 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.