Provider Demographics
NPI:1053124875
Name:ACHLADIS, MATTHEW T
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:T
Last Name:ACHLADIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 TIFFANY BLVD S
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44514-1977
Mailing Address - Country:US
Mailing Address - Phone:330-629-2955
Mailing Address - Fax:330-629-2956
Practice Address - Street 1:1051 TIFFANY BLVD S
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44514-1977
Practice Address - Country:US
Practice Address - Phone:330-629-2955
Practice Address - Fax:330-629-2956
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician