Provider Demographics
NPI:1356466064
Name:HALLORAN, MATTHEW (PLMHP)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:HALLORAN
Suffix:
Gender:M
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 PEOPLES RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-4670
Mailing Address - Country:US
Mailing Address - Phone:402-682-9694
Mailing Address - Fax:402-682-9678
Practice Address - Street 1:424 W 23RD ST
Practice Address - Street 2:SUITES D & E
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-1211
Practice Address - Country:US
Practice Address - Phone:402-753-6349
Practice Address - Fax:402-753-6359
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical