Individual provider Active NPI

Melissa Martin, MA, LPC

  • Counselor
  • Plymouth, MI
National Provider Identifier
1023691003
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
600 N Evergreen St
Plymouth, MI 48170-1173
Phone
(734) 277-1810
NPI assigned
Apr 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

600 N Evergreen St
Plymouth, MI 48170-1173

Mailing address

600 N Evergreen St
Plymouth, MI 48170-1173
Phone (734) 277-1810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240405003032 MI Practitioner - Mental Health Counselor 3375981517 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Peaceful Mind Counseling Services LLC Counselor CurrentSince Feb 20, 2024 Accepting new patients
Mkaye Counseling, PLLC Counselor CurrentSince May 25, 2024 Accepting new patients
Sasco Dexter LLC PastSince Feb 20, 2024 Accepting new patients

Locations

2820 Baker Rd
Ste 100
Dexter, MI 48130
Phone (734) 580-2920

705 S Main St
Plymouth, MI 48170
Phone (734) 277-1810

Organizations & group practices 3

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": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1023691003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N EVERGREEN ST",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701173",
            "telephone_number": "734-277-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N EVERGREEN ST",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701173",
            "telephone_number": "734-277-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MELISSA",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-28",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

Verify at the official NPI Registry.