Provider Demographics
NPI:1013591510
Name:BALABAN, MATTHEW (MS, LPC, NCC, CADC)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:BALABAN
Suffix:
Gender:M
Credentials:MS, LPC, NCC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 OAK HILLS DR
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-9739
Mailing Address - Country:US
Mailing Address - Phone:410-952-2888
Mailing Address - Fax:
Practice Address - Street 1:10 OAK HILLS DR
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-9739
Practice Address - Country:US
Practice Address - Phone:410-952-2888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC013280101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional