Provider Demographics
NPI:1326385733
Name:MATNEY, ANN MAURINE (LCPC)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:MAURINE
Last Name:MATNEY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 FAIRWAY DR STE 107
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-5819
Mailing Address - Country:US
Mailing Address - Phone:406-581-1138
Mailing Address - Fax:
Practice Address - Street 1:1001 OAK ST STE 205
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-8757
Practice Address - Country:US
Practice Address - Phone:406-581-1138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2021-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLMT-LMT-LIC-1049173C00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No173C00000XOther Service ProvidersReflexologist