Provider Demographics
NPI:1104189240
Name:MATKOWSKY, ALBERT S (MA, MLADC)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:S
Last Name:MATKOWSKY
Suffix:
Gender:M
Credentials:MA, MLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WOODFIELD ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-2055
Mailing Address - Country:US
Mailing Address - Phone:603-809-6344
Mailing Address - Fax:
Practice Address - Street 1:15 WOODFIELD ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-2055
Practice Address - Country:US
Practice Address - Phone:603-809-6344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0363101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)