Individual provider Active NPI

Michael Martinez, M.A., P.L.P.C.

  • Counselor
  • Saint Louis, MO
National Provider Identifier
1093165250
Registry record updated Jun 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
2015006044 Issued in MO
Practice address
330 N Gore Ave
Saint Louis, MO 63119-1600
Phone
(314) 919-4700
NPI assigned
Jun 20, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 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 2015006044 MO Primary

Addresses

Primary practice location

330 N Gore Ave
Saint Louis, MO 63119-1600

Mailing address

500 N Grand Blvd
Apt 510
Saint Louis, MO 63103-1005
Phone (314) 919-4700

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2015006044MOMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1093165250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N GRAND BLVD",
            "address_2": "APT 510",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631031005",
            "telephone_number": "314-919-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N GORE AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631191600",
            "telephone_number": "314-919-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "M.A., P.L.P.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-20",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": "2015006044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

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

Verify at the official NPI Registry.