Provider Demographics
NPI:1922869288
Name:MATT GILBERT, PSYD PLLC
Entity Type:Organization
Organization Name:MATT GILBERT, PSYD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:502-498-3296
Mailing Address - Street 1:1169 EASTERN PARKWAY
Mailing Address - Street 2:STE 3414
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40217-1420
Mailing Address - Country:US
Mailing Address - Phone:502-498-3296
Mailing Address - Fax:
Practice Address - Street 1:1169 EASTERN PARKWAY
Practice Address - Street 2:STE 3414
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1420
Practice Address - Country:US
Practice Address - Phone:502-498-3296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)