Individual provider Active NPI

Nicole Mateo, LPC-S

  • Professional Counselor
  • Palm Coast, FL
National Provider Identifier
1821272808
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
68091 Issued in TX
Practice address
9 Old Kings Rd N # 1193
Palm Coast, FL 32137-4603
Phone
(386) 576-2570
NPI assigned
Dec 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X IMH6096 FL
Professional Counselor 101YP2500X 68091 TX Primary

Addresses

Primary practice location

9 Old Kings Rd N # 1193
Palm Coast, FL 32137-4603

Mailing address

9 Old Kings Rd N # 1193
Palm Coast, FL 32137-4603
Phone (386) 576-2570

Other identifiers 2

IdentifierTypeStateIssuer
891LPROtherTXBLUE CROSS BLUE SHIELD
281842907MedicaidTX

Other names 1

  • Nicole Flechas Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251031003910 FL Practitioner - Mental Health Counselor 9436648045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1550 Wewatta St
Suite 3141
Denver, CO 80202-6299

317 Stonehurst Pkwy
Saint Augustine, FL 32092-5017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
IMH6096FLMDProfessional Counselor
68091TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Olive Tree Maternal Wellness Center PLLC Current Accepting new patients
The Porter Medical Group P.C. CurrentSince Aug 26, 2025 Accepting new patients

Locations

1550 Wewatta St
Ste 3141
Denver, CO 80202
Phone (833) 777-7208

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1821272808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 OLD KINGS RD N # 1193",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321374603",
            "telephone_number": "386-576-2570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 OLD KINGS RD N # 1193",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321374603",
            "telephone_number": "386-576-2570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATEO",
        "first_name": "NICOLE",
        "credential": "LPC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-26",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "IMH6096",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "68091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "891LPR",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281842907",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "FLECHAS",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Palm Coast, FL

Sources for this page

Verify at the official NPI Registry.