Organization
MODERN MENTAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACLYN MATTHEWS LMHC (OWNER)
(848) 299-9329
Entity
Organization
Contact information
Practice address
3000 GULF TO BAY BLVD STE 312, CLEARWATER, FL 33759-4304
(727) 279-0101
Mailing address
1221 34TH AVE N, ST PETERSBURG, FL 33704-1842
(848) 299-9329
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TP2701X
Group Psychotherapy Psychologist
Primary
—
—
Other
Enumeration date
07/02/2020
Last updated
07/02/2020
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