Matthew Kempf, LCDCII
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · McDermott, OH
NPI 1972230993 · NPPES record last updated Oct 12, 2023
Key facts
- NPI
- 1972230993
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- LCDCII.091009 (OH)
- Practice address
- 9620 Careys Run Pond Creek Road
McDermott, OH 45652 - Phone
- (740) 858-6683
- NPI assigned
- Aug 2, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCDCII.091009 | OH | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Moving Forward Residential LLC | Current |
Accepting new patients | |
| Moving Forward Residential LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | OH | ||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCDCII.091009 | OH | Yes |
Addresses
Primary practice location
9620 Careys Run Pond Creek Road
McDermott, OH 45652
Mailing address
8416 Careys Run Pond Creek Rd
West Portsmouth, OH 45663-9045
Phone (740) 981-2272
Other practice location 1
7175 State Route 104
Mc Dermott, OH 45652-8899
Phone (740) 858-6683
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0001065 | Medicaid | OH |
Other providers in McDermott, OH
- Dustin Anthony
- Brittany Joanne Bolton
- Michael Hall
- Brooke James
- Jonah Lawson
- Clayton Meadows
- Ryan Rawlins
- Matthew Joseph Romanello
- Scioto Ambulance District
All providers in McDermott, OH · Addiction (Substance Use Disorder) Counselor in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.