Individual provider Active NPI

Melinda Matulis Ali, LSW, CSW-I

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1851897805
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
IC-1519 Issued in NV
Practice address
4055 Spencer St Ste 118
Las Vegas, NV 89119-5250
Phone
(702) 799-9710
NPI assigned
Mar 30, 2018
Last updated
Jan 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X IC-1519 NV Primary

Addresses

Primary practice location

4055 Spencer St Ste 118
Las Vegas, NV 89119-5250

Mailing address

4055 Spencer St Ste 118
Las Vegas, NV 89119-5250
Phone (702) 799-9710

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221220002161 NV Practitioner - Clinical Social Worker 9436528122 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
IC-1519NVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Behavioral Health CurrentSince Oct 10, 2022 Accepting new patients
LKBG LLC Clinical PastSince Oct 10, 2022 Accepting new patients

Locations

2775 S Jones Blvd
Ste 101
Las Vegas, NV 89146
Phone (702) 685-3300

4055 Spencer St
Ste 118
Las Vegas, NV 89119
Phone (702) 218-6496

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1851897805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 SPENCER ST STE 118",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195250",
            "telephone_number": "702-799-9710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 SPENCER ST STE 118",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195250",
            "telephone_number": "702-799-9710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "MELINDA",
        "middle_name": "MATULIS",
        "credential": "LSW, CSW-I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-30",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "IC-1519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.