Provider Demographics
NPI:1659899953
Name:HALE, MATTHEW A (LIMFT)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:A
Last Name:HALE
Suffix:
Gender:M
Credentials:LIMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4629 AICHOLTZ RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45244-1551
Mailing Address - Country:US
Mailing Address - Phone:513-752-1555
Mailing Address - Fax:
Practice Address - Street 1:4633 AICHOLTZ RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45244-1447
Practice Address - Country:US
Practice Address - Phone:513-752-1555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-07
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF.1700021106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist