Active NPI
Prudence Martin
- Mental Health Counselor
- Greenville, SC
National Provider Identifier
1003500265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 12409
- Practice address
- 25 Woods Lake Rd Ste 712
Greenville, SC 29607-2765 - Phone
- (864) 242-0005
- NPI assigned
- Jun 8, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 12409 | SC | Primary |
Addresses
Primary practice location
25 Woods Lake Rd Ste 712
Greenville, SC 29607-2765
Mailing address
104 Meilland Dr
Greer, SC 29650-4421
Phone (864) 444-7959
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783987200000",
"number": "1003500265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 MEILLAND DR",
"city": "GREER",
"state": "SC",
"postal_code": "296504421",
"telephone_number": "864-444-7959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 WOODS LAKE RD STE 712",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296072765",
"telephone_number": "864-242-0005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "PRUDENCE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-08",
"last_updated": "2026-07-14",
"certification_date": "2026-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "SC",
"license": "12409",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.