Provider Demographics
NPI:1013350024
Name:NORDENHOLD, MATTHEW (MA)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:NORDENHOLD
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30A WASHINGTON PL E
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-1715
Mailing Address - Country:US
Mailing Address - Phone:914-886-3415
Mailing Address - Fax:
Practice Address - Street 1:30A WASHINGTON PL E
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603-1715
Practice Address - Country:US
Practice Address - Phone:914-886-3415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-09
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY991184103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool