Individual
DR. MATTHEW SCOTT BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1222 S VISTA AVE, BOISE, ID 83705-2530
(208) 837-5121
(208) 906-8234
Mailing address
1222 S VISTA AVE, BOISE, ID 83705-2530
(208) 837-5121
(208) 906-8234
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
394
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14194
—
ND
01
—
BEN28274
BCBS OF ND
ND
Enumeration date
06/05/2007
Last updated
07/23/2025
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