JENNIFER MATILLA (NPI# 1821462755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821462755 |
| Entity Type | Individual |
| Full Name | JENNIFER MATILLA |
| Practice Address |
6507 Gunn Hwy Tampa FL 33625-4021 |
| Mailing Address |
11651 Sw 64th Ave Miami FL 33156 |
| Practice Telephone | 8133742070 |
| Practice Fax Number | 8134894347 |
| Mailing Telephone | 2396541757 |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2015-11-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MH 13534 | FL | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
LPC37PC0024280 | NJ | Behavioral Health & Social Service Providers |
| Street Address |
6507 GUNN HWY |
| City | TAMPA |
| State | FL |
| Zip Code | 33625-4021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659520526 | Jennifer Rose Phelps | Behavioral Analyst | 6507 Gunn Hwy, Tampa, FL 33625-4021 | 2008-09-15 |
| 1760857940 | Samantha E Cox | Behavioral Analyst | 6507 Gunn Hwy, Tampa, FL 33625-4021 | 2015-12-14 |
| 1639544810 | Leslie Orihuela | Behavioral Analyst | 6507 Gunn Hwy, Tampa, FL 33625-4021 | 2015-12-14 |
| 1831567866 | Alicia Allan | Behavioral Analyst | 6507 Gunn Hwy, Tampa, FL 33625-4021 | 2015-09-08 |
| 1598133852 | Rachel Suberman | Behavioral Analyst | 6507 Gunn Hwy, Tampa, FL 33625-4021 | 2015-09-03 |
| 1235507567 | Ashley Walker | Behavioral Analyst | 6507 Gunn Hwy, Tampa, FL 33625-4021 | 2015-09-03 |
| 1184092421 | Melissa Santiago | Behavioral Analyst | 6507 Gunn Hwy, Tampa, FL 33625-4021 | 2015-09-03 |
| 1417323015 | Grace Richardson | Behavioral Analyst | 6507 Gunn Hwy, Tampa, FL 33625-4021 | 2015-08-18 |
| 1679949283 | Lorin Bullara | Behavioral Analyst | 6507 Gunn Hwy, Tampa, FL 33625-4021 | 2015-08-18 |
| 1356721153 | Ariel Gottlieb | Behavioral Analyst | 6507 Gunn Hwy, Tampa, FL 33625-4021 | 2015-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790316222 | Kyle Raymond Schindler | Physical Therapist | 12891 Citrus Park Dr, Tampa, FL 33625 | 2020-02-03 |
| 1558923771 | Rose Alexis | Nurse Practitioner | 5357 Enrlich Road, Tampa, FL 33625 | 2019-07-08 |
| 1831655380 | Tampa Family Health Centers, Inc | Clinic/Center | 12085 W. Hillsborough Ave., Tampa, FL 33625 | 2019-02-20 |
| 1083067664 | Adventist Health System/sunbelt, Inc. | Clinic/Center | 6930 Gunn Hwy, Tampa, FL 33625 | 2016-07-19 |
| 1285012773 | Be Bellus Med Spa | Clinic/Center | 6914 W Linebaugh Ave, Suite 102, Tampa, FL 33625 | 2015-05-15 |
| 1649519877 | Brenda Lee Figueroa | Nurse Practitioner | 6702 West Linebaugh Ave., Tampa, FL 33625 | 2013-02-07 |
| 1639424930 | Sheriece Sadberry | Psychologist | 6922 W Linebaugh Ave Ste 101c, Tampa, FL 33625 | 2012-07-23 |
| 1619244191 | Mariana Velandia | Counselor | 12819 Pacifica Pl, Tampa, FL 33625 | 2011-11-28 |
| 1245507003 | Oleston Chiropractic, P.a. | Chiropractor | 6575 Gunn Hwy, Tampa, FL 33625 | 2011-11-22 |
| 1891074027 | Christine M Klocek | Behavioral Analyst | 6543 Gunn Highway, Tampa, FL 33625 | 2011-08-05 |
| Find all providers in zip 33625 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316546146 | Rebecca M Slack | Counselor | 4422 E Columbus Dr Fl 33605, Tampa, FL 33605-3233 | 2020-10-22 |
| 1003415852 | Betsy Rose Rodriguez | Counselor | 1101 E Cumberland Ave # 201h-132, Tampa, FL 33602-4231 | 2020-10-22 |
| 1124626155 | Laverne Brown | Counselor | 10964 Brightside Dr, Tampa, FL 33624-7007 | 2020-10-12 |
| 1639786064 | Brittany Richardson Smiley | Counselor | 1610 E Osborne Ave, Tampa, FL 33610-6045 | 2020-09-29 |
| 1356957492 | Latoya K Claxton | Counselor | 17106 Carrington Park Dr Apt 601, Tampa, FL 33647-2627 | 2020-09-22 |
| 1679188718 | Jessica Marie Graham | Counselor | 3038 W Bearss Ave, Tampa, FL 33618-1811 | 2020-09-15 |
| 1952915795 | Kathy Thompson | Counselor | 4115 W Spruce St Ste 205, Tampa, FL 33607-2485 | 2020-08-31 |
| 1467066233 | Samantha Tubbs-crews, Lmhc | Counselor | 1211 N West Shore Blvd Ste 100, Tampa, FL 33607-4601 | 2020-08-31 |
| 1699388744 | R.e.s.e.t. Counseling Services LLC | Counselor | 1806 E Hanna Ave, Tampa, FL 33610-3543 | 2020-08-28 |
| 1700401056 | Jamie Tyus | Counselor | 3825 Henderson Blvd Ste 404, Tampa, FL 33629-5012 | 2020-06-12 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.