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NPI Code Detail

MEDICARE: MS. MELISSA L. MATHERSON LMFT

MEDICARE: MS. MELISSA L. MATHERSON LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistMFC46668CA
2106H00000XMarriage & Family TherapistMT2697FL

General Provider Information

NPI Number : 1043334675
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MELISSA L. MATHERSON LMFT
Provider Business Mailing Address
First Line : 8570 GRANITE CT STE 101
Second Line :
City : FORT MYERS
State : FL
Zip : 33908-4240
Country : US
Telephone Number : 833-769-3524
Fax Number :
Provider Business Practice Location Address
First Line : 8570 GRANITE CT STE 101
Second Line :
City : FORT MYERS
State : FL
Zip : 33908-4240
Country : US
Telephone Number : 833-769-3524
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 12/18/2025

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