Provider Demographics
NPI:1023296886
Name:SUTTON, MATTHEW (LPC-S, LPE-I)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:SUTTON
Suffix:
Gender:M
Credentials:LPC-S, LPE-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-2930
Mailing Address - Country:US
Mailing Address - Phone:870-476-3058
Mailing Address - Fax:870-455-6435
Practice Address - Street 1:210 E 7TH ST STE 6
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-4457
Practice Address - Country:US
Practice Address - Phone:870-476-3058
Practice Address - Fax:870-455-6435
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-04
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1007053101YM0800X
AR13-38EI103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health