Provider Demographics
NPI:1205387669
Name:ORMONDE, MATTHEW PAUL
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:PAUL
Last Name:ORMONDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 MAINLAND ST
Mailing Address - Street 2:APT2
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-4510
Mailing Address - Country:US
Mailing Address - Phone:508-685-0574
Mailing Address - Fax:
Practice Address - Street 1:49 MAITLAND ST
Practice Address - Street 2:APT2
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-4510
Practice Address - Country:US
Practice Address - Phone:508-685-0574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor