Provider Demographics
NPI:1023288578
Name:HOLLORAN, MATTHEW C (JD, LPC, CACIII)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:C
Last Name:HOLLORAN
Suffix:
Gender:M
Credentials:JD, LPC, CACIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2299 PEARL ST STE 402
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-4673
Mailing Address - Country:US
Mailing Address - Phone:720-837-0236
Mailing Address - Fax:
Practice Address - Street 1:2299 PEARL ST STE 402
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302
Practice Address - Country:US
Practice Address - Phone:720-837-0236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-11
Last Update Date:2018-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5451101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional