Kenneth Leon Martin, MA, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4941 Issued in SC

Practice address

105 Paces Brook Ave
#10518
Columbia, SC 29212-1642

Phone

(803) 467-4125

Fax

(803) 497-3920

NPI assigned

Oct 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC, NC2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• It'S Your Move

  • Counselor
  • Columbia, SC
  • NPI 1396214987
  Medicare reassignment NPD
• It'S Your Move

  • Primary Care Clinic/Center
  • Columbia, SC
  • NPI 1568114999

  NC

  Medicare reassignment NPD
• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  SC

  Medicare reassignment

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315267200000",
    "number": "1093899007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 PACES BROOK AVE",
            "address_2": "APT 10518",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292121642",
            "telephone_number": "803-467-4125",
            "fax_number": "803-497-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 PACES BROOK AVE",
            "address_2": "#10518",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292121642",
            "telephone_number": "803-467-4125",
            "fax_number": "803-497-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KENNETH",
        "middle_name": "LEON",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2011-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "4941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Bruce Martin, C.R.N.A.
• Justin Louis Martin, PT
• Karly Martin
• Katie Martin
• Kaylee Martin, MD
• Latasha Martin, ED.S, LPC
• Laurajane Elizabeth Martin, APRN
• Linda K Martin
• Marianne Martin, OTR/L
• Megan Martin, RBT

• Mental Health Counselor in Columbia, SC
• Providers in Columbia, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; 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.