Provider Demographics
NPI:1235475393
Name:BASSETT, MATHEW J (BHT)
Entity Type:Individual
Prefix:MR
First Name:MATHEW
Middle Name:J
Last Name:BASSETT
Suffix:
Gender:M
Credentials:BHT
Other - Prefix:MR
Other - First Name:MATHEW
Other - Middle Name:J
Other - Last Name:BASSETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BHT
Mailing Address - Street 1:32 SOUTH MACDONALD STREET
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210
Mailing Address - Country:US
Mailing Address - Phone:480-833-0143
Mailing Address - Fax:480-264-0687
Practice Address - Street 1:32 SOUTH MACDONALD STREET
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210
Practice Address - Country:US
Practice Address - Phone:480-833-0143
Practice Address - Fax:480-264-0687
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)