Matthew Scott Bennett, PHD
Individual provider Active NPI Clinical Psychologist · Boise, ID
NPI 1316149792 · NPPES record last updated Jul 23, 2025
Key facts
- NPI
- 1316149792
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 394 (ND)
- Practice address
- 1222 S Vista Ave
Boise, ID 83705-2530 - Phone
- (208) 837-5121
- Fax
- (208) 906-8234
- NPI assigned
- Jun 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 394 | ND | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Krumm & Co., PLLC | Psychologist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 394 | ND | Yes |
Addresses
Primary practice location
1222 S Vista Ave
Boise, ID 83705-2530
Mailing address
1222 S Vista Ave
Boise, ID 83705-2530
Phone (208) 837-5121
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BEN28274 | Other | ND | BCBS OF ND |
| 14194 | Medicaid | ND |
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.