Individual
NICOLE MATEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC-S
Contact information
Practice address
9 OLD KINGS RD N # 1193, PALM COAST, FL 32137-4603
(386) 576-2570
Mailing address
9 OLD KINGS RD N # 1193, PALM COAST, FL 32137-4603
(386) 576-2570
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
68091
TX
101YP2500X
Professional Counselor
IMH6096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
281842907
—
TX
01
—
891LPR
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/26/2007
Last updated
03/31/2026
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