Provider Demographics
NPI:1932841814
Name:MATOS, LINETTE (LMHC)
Entity type:Individual
Prefix:
First Name:LINETTE
Middle Name:
Last Name:MATOS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 MAIN ST UNIT 181
Mailing Address - Street 2:
Mailing Address - City:EAST ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11518-1702
Mailing Address - Country:US
Mailing Address - Phone:516-522-0552
Mailing Address - Fax:516-324-3066
Practice Address - Street 1:138 MAIN ST UNIT 181
Practice Address - Street 2:
Practice Address - City:EAST ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11518-1702
Practice Address - Country:US
Practice Address - Phone:516-522-0552
Practice Address - Fax:516-324-3066
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-11
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP114634101YM0800X
NY015032101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health