Active NPI
Matthew Martin Donlan, DBH, MBA
- Counselor
- Bourne, MA
National Provider Identifier
1518364264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 13071
- Practice address
- 61 Tara Ter
Bourne, MA 02532-3883 - Phone
- (617) 877-9594
- NPI assigned
- Nov 24, 2014
- Last updated
- Nov 9, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 13071 | MA | Primary |
Addresses
Primary practice location
61 Tara Ter
Bourne, MA 02532-3883
Mailing address
61 Tara Ter
Bourne, MA 02532-3883
Phone (617) 877-9594
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Business Administration
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13071 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636416000000",
"number": "1518364264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "61 TARA TER",
"city": "BOURNE",
"state": "MA",
"postal_code": "025323883",
"telephone_number": "617-877-9594"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "61 TARA TER",
"city": "BOURNE",
"state": "MA",
"postal_code": "025323883",
"telephone_number": "617-877-9594"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONLAN",
"first_name": "MATTHEW",
"middle_name": "MARTIN",
"name_prefix": "Dr.",
"credential": "DBH, MBA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-11-24",
"last_updated": "2021-11-09",
"certification_date": "2021-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MA",
"license": "13071",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bourne, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.