Provider Demographics
NPI:1497958565
Name:BIALKOWSKI, MATTHEW (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:BIALKOWSKI
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 LUDDINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-3223
Mailing Address - Country:US
Mailing Address - Phone:973-546-2243
Mailing Address - Fax:973-777-1434
Practice Address - Street 1:60 HADLEY AVE
Practice Address - Street 2:SUITE A
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2741
Practice Address - Country:US
Practice Address - Phone:973-779-2878
Practice Address - Fax:973-777-1434
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00221700101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional