MEDICARE: DAVID MATE MSW, LCSW

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	1041C0700X	Clinical Social Worker	SW23197	FL

General Provider Information

NPI Number	:	1285597724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID MATE MSW, LCSW

Provider Business Mailing Address
First Line	:	1049 NW WINBORN WAY
Second Line	:
City	:	LAKE CITY
State	:	FL
Zip	:	32055-1806
Country	:	US
Telephone Number	:	386-754-9926
Fax Number	:	386-754-9928

Provider Business Practice Location Address
First Line	:	1049 NW WINBORN WAY
Second Line	:
City	:	LAKE CITY
State	:	FL
Zip	:	32055-1806
Country	:	US
Telephone Number	:	386-754-9926
Fax Number	:	386-754-9928

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	12/03/2025

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