MEDICARE: HEATHER MATURO COUNSELING

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
1	251S00000X	Community/Behavioral Health Agency	MH 12745	FL

General Provider Information

NPI Number	:	1043743511
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEATHER MATURO COUNSELING

Provider Business Mailing Address
First Line	:	7901 4TH ST N
Second Line	:	SUITE 322
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33702-4305
Country	:	US
Telephone Number	:	219-508-2465
Fax Number	:

Provider Business Practice Location Address
First Line	:	7901 4TH ST N
Second Line	:	SUITE 322
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33702-4305
Country	:	US
Telephone Number	:	219-508-2465
Fax Number	:

Authorized Official
Title or Position	:	LICENSED MENTAL HEALTH COUNSELOR
Name	:	HEATHER MATURO
Credential	:
Telephone Number	:	219-508-2465

Provider Enumeration Date	:	04/11/2017
Last Update Date	:	04/11/2017

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Directions to “HEATHER MATURO COUNSELING ” Practice Location

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