Individual
MATTHEW HALLOWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1020 W MAIN ST STE 100-I, BOISE, ID 83702-5789
(208) 614-0054
(208) 694-7713
Mailing address
3033 N FIVE MILE RD APT 101, BOISE, ID 83713-5202
(208) 614-0054
(208) 694-7713
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
LCSW-40551
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124526249
—
ID
Enumeration date
01/23/2018
Last updated
10/24/2025
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