Provider Demographics
NPI:1952488447
Name:HUTT, MATTHEW MARTIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:MARTIN
Last Name:HUTT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2208 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-1970
Mailing Address - Country:US
Mailing Address - Phone:308-632-8080
Mailing Address - Fax:308-632-8084
Practice Address - Street 1:2208 BROADWAY
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-1970
Practice Address - Country:US
Practice Address - Phone:308-632-8080
Practice Address - Fax:308-632-8084
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE331103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE470794928-26Medicaid
NE470794928-26Medicaid
NER96431Medicare UPIN