Individual provider Active NPI

Matthew Scott Dustin, LCSW

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1861720047
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6118-C Issued in NV
Practice address
6070 S Eastern Ave
#200
Las Vegas, NV 89119-3171
Phone
(702) 292-3774
NPI assigned
Nov 25, 2009
Last updated
Apr 4, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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 6118-C NV Primary

Addresses

Primary practice location

6070 S Eastern Ave
#200
Las Vegas, NV 89119-3171

Mailing address

3421 Brayton Mist Dr
North Las Vegas, NV 89081-6527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20151019000966 UT Practitioner - Clinical Social Worker 5597074302 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

3903 Harrison Blvd
Suite 300
Ogden, UT 84403-2362
Phone (801) 387-5600

5770 S 1500
Primary Childrens Behavioral Health
Salt Lake City, UT 84123-5216
Phone (801) 265-3412

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6118-CNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Oct 1, 2015 Accepting new patients
Ihc Health Services Inc CurrentSince Oct 1, 2015 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc CurrentSince Jun 1, 2017 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
All About You Counseling and Support Services Clinical Past Accepting new patients
All About You Counseling and Support Services Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

1225 E Fort Union Blvd
Ste 315
Midvale, UT 84047
Phone (801) 233-4100

3903 Medical Dr
Ste 300
Ogden, UT 84403
Phone (801) 387-4930

745 S 2000 W
Syracuse, UT 84075
Phone (801) 525-2400

5770 S 1500 W
Taylorsville, UT 84123
Phone (801) 265-3000

Organizations & group practices 7

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": "1259107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333497600000",
    "number": "1861720047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 BRAYTON MIST DR",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890816527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6070 S EASTERN AVE",
            "address_2": "#200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891193171",
            "telephone_number": "702-292-3774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUSTIN",
        "first_name": "MATTHEW",
        "middle_name": "SCOTT",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-25",
        "last_updated": "2012-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "6118-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.