Provider Demographics
NPI:1861161788
Name:LUVISI, MATTHEW BRYAN (MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:BRYAN
Last Name:LUVISI
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:PO BOX 6154
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59771-6154
Mailing Address - Country:US
Mailing Address - Phone:406-404-6291
Mailing Address - Fax:406-551-4624
Practice Address - Street 1:602 S FERGUSON AVE STE 6
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6483
Practice Address - Country:US
Practice Address - Phone:406-404-6291
Practice Address - Fax:406-551-4624
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT504821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT50482OtherMONTANA BOARD OF BEHAVIORAL HEALTH