Jennifer Matilla

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH 13534 Issued in FL

Practice address

6507 Gunn Hwy
Tampa, FL 33625-4021

Phone

(813) 374-2070

Fax

(813) 489-4347

NPI assigned

Nov 16, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jem Therapy Services, LLC

  • Mental Health Counselor
  • Orange Park, FL
  • NPI 1558048405
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1447632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447632000000",
    "number": "1821462755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11651 SW 64TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33156",
            "telephone_number": "239-654-1757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6507 GUNN HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336254021",
            "telephone_number": "813-374-2070",
            "fax_number": "813-489-4347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATILLA",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-16",
        "last_updated": "2015-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 13534",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "LPC37PC0024280",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Matias-Hernandez
• Felix Antonio Matias, M.S., CCC-SLP
• Brian Matier, M.D.
• David Matilla Oro, PTA
• Eduardo J Matilla
• Matthew Thomas Matisko, DPT
• Garett R Matley
• Matmed LLC (Miami Wellness)
• Ayled Matos Diaz
• Daylan Matos Perez

• Mental Health Counselor in Tampa, FL
• Providers in Tampa, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.