Individual provider Active NPI

Matthew J Nutt, LCSW

  • Clinical Social Worker
  • Bangor, ME
National Provider Identifier
1497856876
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC7720
Practice address
175 Union St Ste C
Bangor, ME 04401-6100
Phone
(207) 478-8645
Fax
(207) 514-0726
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC7720 Primary

Addresses

Primary practice location

175 Union St Ste C
Bangor, ME 04401-6100

Mailing address

175 Union St Ste C
Bangor, ME 04401-6100
Phone (207) 478-8645

Other practice location 1

242 Brunswick St
Old Town, ME 04468-1613
Phone (207) 827-6128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050628000634 ME Practitioner - Clinical Social Worker 4486699667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SweetserGroup PAC ID 8325946213, 138 clinicians

Practice addresses (Care Compare)

50 Moody St
Saco, ME 04072-1536

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sweetser CurrentSince Nov 26, 2011 Accepting new patients

Locations

28 Sweetser Dr
Belfast, ME 04915
Phone (207) 284-5981

50 Moody St
Saco, ME 04072
Phone (207) 284-5981

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1497856876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 UNION ST STE C",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016100",
            "telephone_number": "207-478-8645",
            "fax_number": "207-514-0726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 UNION ST STE C",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016100",
            "telephone_number": "207-478-8645",
            "fax_number": "207-514-0726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "242 Brunswick St",
            "address_purpose": "LOCATION",
            "city": "Old Town",
            "state": "ME",
            "postal_code": "044681613",
            "country_code": "US",
            "telephone_number": "207-827-6128",
            "fax_number": "207-990-1248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUTT",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "LC7720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.