Individual provider Active NPI

Matthew McKelvey, CADC-D

  • Counselor
  • Petoskey, MI
National Provider Identifier
1003690132
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
704 Emmet St
Petoskey, MI 49770-2910
Phone
(231) 347-5511
NPI assigned
Aug 21, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

704 Emmet St
Petoskey, MI 49770-2910

Mailing address

704 Emmet St
Petoskey, MI 49770-2910
Phone (231) 347-5511

Other practice location 1

2236 E Mitchell Rd Ste 5
Petoskey, MI 49770-9604
Phone (231) 347-5511

Other practice location 2

520 N Main St Ste 202
Cheboygan, MI 49721-1162
Phone (231) 597-9234

Other practice location 3

118 Rush Street
Petoskey, MI 49770
Phone (123) 134-7551

Other practice location 4

114 Rush St
Petoskey, MI 49770-2920
Phone (231) 347-5511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Hall, Inc. Past Accepting new patients
Harbor Hall, Inc. Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1003690132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 EMMET ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702910",
            "telephone_number": "231-347-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 EMMET ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702910",
            "telephone_number": "231-347-5511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2236 E Mitchell Rd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Petoskey",
            "state": "MI",
            "postal_code": "497709604",
            "country_code": "US",
            "telephone_number": "231-347-5511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "520 N Main St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Cheboygan",
            "state": "MI",
            "postal_code": "497211162",
            "country_code": "US",
            "telephone_number": "231-597-9234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "118 Rush Street",
            "address_purpose": "LOCATION",
            "city": "Petoskey",
            "state": "MI",
            "postal_code": "49770",
            "country_code": "US",
            "telephone_number": "123-134-7551",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "114 Rush St",
            "address_purpose": "LOCATION",
            "city": "Petoskey",
            "state": "MI",
            "postal_code": "497702920",
            "country_code": "US",
            "telephone_number": "231-347-5511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKELVEY",
        "first_name": "MATTHEW",
        "credential": "CADC-D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.