Provider Demographics
NPI:1851522171
Name:MATTHEWS, GARY (LCPC, PLLC)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:LCPC, PLLC
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:MATTHEWS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2953 LILY DR
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-6022
Mailing Address - Country:US
Mailing Address - Phone:406-579-8577
Mailing Address - Fax:
Practice Address - Street 1:2953 LILY DR
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6022
Practice Address - Country:US
Practice Address - Phone:406-579-8577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist