Amanda Beth Martin

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3551-226 Issued in WI

Practice address

E7475 Rawhide Rd
New London, WI 54961-9025

Phone

(877) 300-9101

NPI assigned

Dec 26, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: amanda.martin@25254901.chartlogic.direct-ci.com

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.

• Rawhide Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New London, WI
  • NPI 1841334620
  NPD (past)
• Wellqor Psychological Services, PC

  • Clinical Psychologist
  • Melville, NY
  • NPI 1063920841
  NPD (past)

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

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1003388380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E7475 RAWHIDE RD",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549619025",
            "telephone_number": "877-300-9101",
            "fax_number": "920-531-2686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "E7475 RAWHIDE RD",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549619025",
            "telephone_number": "877-300-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "AMANDA",
        "middle_name": "BETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-26",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3551-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Lohff, OTR
• Heather A Lutz, APNP
• Catherine M Macmillan, DO
• Maiman Chiropractic Center L.L.C.
• Daniel Edward Maiman, D.C.
• Deborah Sue Martin, MS-CCC-SLP
• Mackenzie Martzahl, COTA
• Manuel A Mendoza, MD
• Samantha A Metko, RDN, IBCLC
• Nina M. Minnear, PT

• Professional Counselor in New London, WI
• Providers in New London, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.