Active NPI
Tahiyya Martin
- Professional Counselor
- Mint Hill, NC
National Provider Identifier
1073909495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- A12289
- Practice address
- 13324 Lawyers Rd Apt a
Mint Hill, NC 28227-9515 - Phone
- (704) 288-6945
- NPI assigned
- Apr 13, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 20315 | NC | |
| Professional Counselor | 101YP2500X | A12289 | NC | Primary |
| Mental Health Counselor | 101YM0800X | A12289 | NC |
Addresses
Primary practice location
13324 Lawyers Rd Apt a
Mint Hill, NC 28227-9515
Mailing address
13324 Lawyers Rd Apt a
Mint Hill, NC 28227-9515
Phone (704) 288-6945
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
| License | State | Type | Specialty |
|---|---|---|---|
| A12289 | NC | MD | Mental Health Counselor |
| 20315 | NC | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| She Heals Journey PLLC | Mental Health | Current | Accepting new patients |
| Simple Life Consulting Group LLC | Past | Accepting new patients |
Locations
5820 E Wt Harris Blvd
Ste 105
Charlotte, NC 28215
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.
-
- Community/Behavioral Health Agency
- Mint Hill, NC
- NPI 1376933978
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461110400000",
"number": "1073909495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13324 LAWYERS RD APT A",
"city": "MINT HILL",
"state": "NC",
"postal_code": "282279515",
"telephone_number": "704-288-6945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13324 LAWYERS RD APT A",
"city": "MINT HILL",
"state": "NC",
"postal_code": "282279515",
"telephone_number": "704-288-6945"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "TAHIYYA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-13",
"last_updated": "2016-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "20315",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "A12289",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "A12289",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mint Hill, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.