Matthew Jordan Kezele, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC-6881 Issued in ID

Practice address

1363 Fillmore St Ste B
Twin Falls, ID 83301-3392

Phone

(208) 734-3670

NPI assigned

May 8, 2018

Last updated

May 8, 2018By the provider in NPPES

Sex

Male

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

State licenses

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1770072522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1363 FILLMORE ST STE B",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1363 FILLMORE ST STE B",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013392",
            "telephone_number": "208-734-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEZELE",
        "first_name": "MATTHEW",
        "middle_name": "JORDAN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-08",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LPC-6881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melody Kerner, LMSW
• Shannon R Kerrick, MSW, LCSW
• Cathi Baily Ketterling, PHARM. D
• Lindsey Ketterling, DPT, CSCS
• Kevin L Hamblin DDS
• William Kezele
• Mohamed Khalifa
• Kimi Recovery Center LLC
• Daniel M King, DPT
• Jonathan Randolph King, D.O.

• Mental Health Counselor in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; 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.