Kailyn Jewell Mattingly, MS, LCMHCA, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A21092 Issued in NC

Practice address

3825 Market St Ste 4
Wilmington, NC 28403-1426

Phone

(910) 777-5575

NPI assigned

Feb 11, 2025

Last updated

Feb 11, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1739232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1467267963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 ALDERWOOD AVE APT 203",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284050219",
            "telephone_number": "571-291-5991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 MARKET ST STE 4",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284031426",
            "telephone_number": "910-777-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "KAILYN",
        "middle_name": "JEWELL",
        "credential": "MS, LCMHCA, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-11",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A21092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Boney Mathis, NP-C
• Kensuke Matsumoto, DMD, MS
• Allyson Renee Matt, PH.D.
• Moira Jane Matthews, COTA/L
• Patricia Matthews
• Evan Gray Maultsby, DC
• Kimberly Maurer, MD
• Emily Katherine Maxey, LCSWA, LCAS
• Maxim Habilitation Services, LLC
• Maxim Healthcare Services, Inc.

• Mental Health Counselor in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.