Individual provider Active NPI

Raymond Perales Martinez, LPC

  • Counselor
  • Tyler, TX
National Provider Identifier
1053734129
Registry record updated Jun 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
68832 Issued in TX
Practice address
3919 Belle Mere St
Tyler, TX 75701-6704
Phone
(936) 615-1481
NPI assigned
Jan 27, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 68832 TX Primary

Addresses

Primary practice location

3919 Belle Mere St
Tyler, TX 75701-6704

Mailing address

3919 Belle Mere St
Tyler, TX 75701-6704
Phone (936) 615-1481

Other names 1

  • Mr. Ray Martinez Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240531000377 TX Practitioner - Mental Health Counselor 7719329028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tyler Counseling Services, LLCGroup PAC ID 5597107896, 4 clinicians

Practice addresses (Care Compare)

1800 Shiloh Rd
Suite 301
Tyler, TX 75703-2456
Phone (903) 871-5017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
68832TXMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Tyler Counseling Services LLC CurrentSince Apr 3, 2024 Accepting new patients

Locations

1800 Shiloh Rd
Ste 301
Tyler, TX 75703
Phone (903) 871-5017

Organizations & group practices 1

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": "1390780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464739200000",
    "number": "1053734129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3919 BELLE MERE ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757016704",
            "telephone_number": "936-615-1481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3919 BELLE MERE ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757016704",
            "telephone_number": "936-615-1481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "RAYMOND",
        "middle_name": "PERALES",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-27",
        "last_updated": "2016-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "68832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAY",
            "last_name": "MARTINEZ",
            "prefix": "MR.",
            "credential": "LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.