Healthcare Provider Details

I. General information

NPI: 1588303671
Provider Name (Legal Business Name): MATEA SUAREZ MA,LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2022
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1718 E OLIVE RD
PENSACOLA FL
32514-7553
US

IV. Provider business mailing address

10019 NIALL DR
PENSACOLA FL
32526-4549
US

V. Phone/Fax

Practice location:
  • Phone: 850-490-7487
  • Fax:
Mailing address:
  • Phone: 850-341-5664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH21202
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH24462
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: