Provider Demographics
NPI:1174319446
Name:D'LUZANSKY, GABRIEL C (LCPC)
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:C
Last Name:D'LUZANSKY
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-2833
Mailing Address - Country:US
Mailing Address - Phone:928-707-0613
Mailing Address - Fax:
Practice Address - Street 1:17 2ND ST E STE 204
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-4500
Practice Address - Country:US
Practice Address - Phone:928-707-0613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-79159101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health