David Michael Martin, MA, MATS, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C3306 Issued in OR

Practice address

1210 SE Oak St
Suite 3
Portland, OR 97214-1427

Phone

(503) 880-1508

Fax

(971) 229-0928

NPI assigned

Jun 19, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

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.

• David Michael Martin LLC

  • Mental Health Counselor
  • Portland, OR
  • NPI 1588472609
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424908800000",
    "number": "1093078677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 SE TIBBETTS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972022043",
            "telephone_number": "503-880-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 SE OAK ST",
            "address_2": "SUITE 3",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141427",
            "telephone_number": "503-880-1508",
            "fax_number": "971-229-0928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "credential": "MA, MATS, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-19",
        "last_updated": "2015-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C3306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500670213",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chenoa Marie Martin, RDH
• Christine Stanley Martin, MD
• Cory Martin
• Daniele K Martin, LMT
• David Graham Martin
• Dawn Lynnea Martin, PHD
• Derrick E Martin Sr.
• Elizabeth Martin, OTD, MHA, OTR/L
• Emily A Martin
• Eric Allen Martin, CADC III, CRM, CPS

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.