Olive Tree Maternal Wellness Center PLLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

OLIVE TREE MATERNAL WELLNESS CENTER PLLC

Practice address

2465 US Highway 1 S
St Augustine, FL 32086-6076

Phone

(770) 896-2659

NPI assigned

Jun 8, 2022

Organization subpart

No

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

Authorized official

Name

Nicole Mateo, LPC, LMHCNPI 1821272808

Title

Owner

Phone

(770) 896-2659

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicole Mateo, LPC-S

  • Professional Counselor
  • Palm Coast, FL
  • NPI 1821272808
  NPD Authorized official

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654646400000",
    "number": "1659000313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2465 US HIGHWAY 1 S",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866076",
            "telephone_number": "770-896-2659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2465 US HIGHWAY 1 S",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866076",
            "telephone_number": "770-896-2659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE TREE MATERNAL WELLNESS CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-02",
        "status": "A",
        "authorized_official_last_name": "MATEO",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-896-2659",
        "authorized_official_credential": "LPC, LMHC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Old Moultrie Surgical Center Inc
• Richard A Oldano, PA
• Linda Ann Olds, L.C.S.W.
• Robert W Olds Jr., MD
• Thomas Olesko
• Agostinho M. Oliveira, D.C.
• Amy Oliver, DPT
• Kristin Marie Oliver, CRNP
• Lisa Olschewske, CD(DONA) CLC
• Beth Erin Olson, DPT

• Community/Behavioral Health Agency in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.