Provider Demographics
NPI:1427947472
Name:YASKUS, MATTHEW DAVID (PCLC)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:DAVID
Last Name:YASKUS
Suffix:
Gender:M
Credentials:PCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 HARVEY LN
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:MT
Mailing Address - Zip Code:59828-9735
Mailing Address - Country:US
Mailing Address - Phone:406-361-1241
Mailing Address - Fax:
Practice Address - Street 1:511 HARVEY LN
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:MT
Practice Address - Zip Code:59828-9735
Practice Address - Country:US
Practice Address - Phone:406-361-1241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT64725101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor