Provider Demographics
NPI:1528586237
Name:HOOPER, MATTHEW VINCENT (LPC, LBS)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:VINCENT
Last Name:HOOPER
Suffix:
Gender:M
Credentials:LPC, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-2406
Mailing Address - Country:US
Mailing Address - Phone:570-906-0476
Mailing Address - Fax:
Practice Address - Street 1:317 DARTMOUTH DRIVE
Practice Address - Street 2:UNIT 3
Practice Address - City:MARSHALLS CREEK
Practice Address - State:PA
Practice Address - Zip Code:18335
Practice Address - Country:US
Practice Address - Phone:570-730-4211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009846101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional