Matthew Kelly, MFT-I, CPC-I, LCADCI

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CI5251 Issued in NV

Practice address

4011 McLeod Dr
Las Vegas, NV 89121-4305

Phone

(979) 251-0014

NPI assigned

Jun 27, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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

Specialty

Marriage and Family Therapist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oasis Counseling LLCGroup PAC ID 3971752684, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Oasis Counseling LLC

  • Mental Health Counselor
  • Henderson, NV
  • NPI 1336400951

  Addiction (Substance Use Disorder)

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1124704663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 CRESTDALE LN APT 64",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891441007",
            "telephone_number": "979-251-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 MCLEOD DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891214305",
            "telephone_number": "979-251-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MATTHEW",
        "credential": "MFT-I, CPC-I, LCADCI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NV",
            "license": "CI5251",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "MI4215",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "07347-LCI",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• La Toya Kelly
• Lillian Kelly
• Louis Kelly
• Mariah Kelly
• Mashawn Kelly
• Maureen Kelly
• Melvina Kelly
• Mercedes Kelly
• Michelle Kelly
• Nakeisha Kelly

• Professional Counselor in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Professional Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.