Matthew James Bennett, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY60482081 Issued in WA

Practice address

1400 112TH Ave SE
Suite 100
Bellevue, WA 98004-6901

Phone

(425) 606-7548

Fax

(425) 657-0844

NPI assigned

Feb 1, 2007

Last updated

Mar 16, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Davken Associates, P.C.

  • Clinical Psychologist
  • Deerfield, IL
  • NPI 1457393159
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426464000000",
    "number": "1003954330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2246 NW HARMONY WAY",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275488",
            "telephone_number": "425-606-7548",
            "fax_number": "425-657-0844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 112TH AVE SE",
            "address_2": "SUITE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980046901",
            "telephone_number": "425-606-7548",
            "fax_number": "425-657-0844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2015-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60482081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natthinee Benjaminson
• Emerson Rose Benner
• Crystal Yvette Bennett, L.M.P.
• Gregrey E Bennett, MD
• Jan Bennett, LMHC
• Stefanie R Benningfield, ND
• Owen Takashi Bennion
• Benoliel Speech and Language, PLLC
• Andrea Miles Benshachar, S.L.P.
• Emmakay Benske

• Clinical Psychologist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.