Individual provider Active NPI

Kelli Matsievskiy, BS

  • Clinical Social Worker
  • Durham, NC
National Provider Identifier
1962022855
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2670 Durham Chapel Hill Blvd
Durham, NC 27707-2829
Phone
(919) 251-9001
NPI assigned
Apr 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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 Primary

Addresses

Primary practice location

2670 Durham Chapel Hill Blvd
Durham, NC 27707-2829

Mailing address

2670 Durham Chapel Hill Blvd
Durham, NC 27707-2829
Phone (919) 251-9001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20250818001545 NC Practitioner - Clinical Social Worker 1456850486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6112 Saint Giles St
Raleigh, NC 27612-7043

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Advaita Integrated Medicine PLLC CurrentSince Jun 1, 2025 Accepting new patients
Veritas Collaborative, LLC Past Accepting new patients

Locations

6112 Saint Giles St
Raleigh, NC 27612
Phone (919) 782-3870

6124 Saint Giles St
Raleigh, NC 27612
Phone (919) 893-4465

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1587427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1962022855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2670 DURHAM CHAPEL HILL BLVD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072829",
            "telephone_number": "919-251-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2670 DURHAM CHAPEL HILL BLVD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072829",
            "telephone_number": "919-251-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSIEVSKIY",
        "first_name": "KELLI",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-21",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.