Healthcare Provider Details

I. General information

NPI: 1316345879
Provider Name (Legal Business Name): SARA MATOS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA CURRY

II. Dates (important events)

Enumeration Date: 12/16/2014
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7205 SE MARICAMP RD
OCALA FL
34472-2105
US

IV. Provider business mailing address

1425 S US 301
SUMTERVILLE FL
33585-5141
US

V. Phone/Fax

Practice location:
  • Phone: 352-680-7000
  • Fax:
Mailing address:
  • Phone: 352-793-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW16681
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: