Individual
MATTHEW KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MFT-I, CPC-I, LCADCI
Contact information
Practice address
4011 MCLEOD DR, LAS VEGAS, NV 89121-4305
(979) 251-0014
Mailing address
451 CRESTDALE LN APT 64, LAS VEGAS, NV 89144-1007
(979) 251-0014
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
07347-LCI
NV
101YM0800X
Mental Health Counselor
MI4215
NV
101YP2500X
Professional Counselor
Primary
CI5251
NV
Other
Enumeration date
06/27/2023
Last updated
06/27/2023
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