Individual provider Active NPI

Martin R Nowak, L.P.C.C.-S

  • Professional Counselor
  • Toledo, OH
National Provider Identifier
1033388756
Registry record updated Apr 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E0007057 Issued in OH
Practice address
1351 S Reynolds Rd Ste B
Toledo, OH 43615-7411
Phone
(419) 787-3780
Fax
(419) 754-2510
NPI assigned
Feb 27, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E0007057 OH Primary

Addresses

Primary practice location

1351 S Reynolds Rd Ste B
Toledo, OH 43615-7411

Mailing address

1351 S Reynolds Rd Ste B
Toledo, OH 43615-7411
Phone (419) 787-3780

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

State licenses

LicenseStateTypeSpecialty
E0007057OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Nowak Lpccs, LLC Professional Current Accepting new patients
Kintsukuroi Mental Health & Wellness Services LLC Current Accepting new patients

Locations

1351 S Reynolds Rd
Ste B
Toledo, OH 43615
Phone (419) 410-1830

Organizations & group practices 2

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": "1204070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1033388756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 S REYNOLDS RD STE B",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436157411",
            "telephone_number": "419-787-3780",
            "fax_number": "419-754-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 S REYNOLDS RD STE B",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436157411",
            "telephone_number": "419-787-3780",
            "fax_number": "419-754-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWAK",
        "first_name": "MARTIN",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "L.P.C.C.-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-27",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E0007057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2020; 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.