Provider Demographics
NPI:1922404862
Name:SHORT, ARTHUR JUSTIN (MPH, MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:JUSTIN
Last Name:SHORT
Suffix:
Gender:M
Credentials:MPH, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11076
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59719-1076
Mailing Address - Country:US
Mailing Address - Phone:406-548-5487
Mailing Address - Fax:
Practice Address - Street 1:141 DISCOVERY DR
Practice Address - Street 2:UNIT 113
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6995
Practice Address - Country:US
Practice Address - Phone:406-548-5487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSWP-LCSW-LIC-83081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical