Provider Demographics
NPI:1639638760
Name:HUUSKO, MATHEW IV (CRSW)
Entity Type:Individual
Prefix:MR
First Name:MATHEW
Middle Name:
Last Name:HUUSKO
Suffix:IV
Gender:M
Credentials:CRSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 FRANKLIN ST STE LL13
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03064-2686
Mailing Address - Country:US
Mailing Address - Phone:603-343-6368
Mailing Address - Fax:603-617-2846
Practice Address - Street 1:12 AMHERST ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03064-2663
Practice Address - Country:US
Practice Address - Phone:603-263-6444
Practice Address - Fax:603-931-3719
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0176101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)