Provider Demographics
NPI:1740092378
Name:MORAN, MATTHEW (LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:MORAN
Suffix:
Gender:M
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 FLAT WATER DR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-7053
Mailing Address - Country:US
Mailing Address - Phone:325-660-7072
Mailing Address - Fax:
Practice Address - Street 1:809 FLAT WATER DR
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-7053
Practice Address - Country:US
Practice Address - Phone:325-660-7072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96449101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional