Individual provider Active NPI

Marci Martinelli, M.S.

  • Marriage & Family Therapist
  • South Lake Tahoe, CA
National Provider Identifier
1104256908
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT84745 Issued in CA
Practice address
1235 Ski Run Blvd Ste 1
South Lake Tahoe, CA 96150-9010
Phone
(530) 721-3525
NPI assigned
Nov 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMF-107 GU
Marriage & Family Therapist 106H00000X LMFT84745 CA Primary

Addresses

Primary practice location

1235 Ski Run Blvd Ste 1
South Lake Tahoe, CA 96150-9010

Mailing address

1235 Ski Run Blvd Ste 1
South Lake Tahoe, CA 96150-9010
Phone (530) 721-3525

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 Science

State licenses

LicenseStateTypeSpecialty
IMF-107GUMDMental Health Counselor
LMFT84745CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1104256908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 SKI RUN BLVD STE 1",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961509010",
            "telephone_number": "530-721-3525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 SKI RUN BLVD STE 1",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961509010",
            "telephone_number": "530-721-3525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINELLI",
        "first_name": "MARCI",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-15",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GU",
            "license": "IMF-107",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT84745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lake Tahoe, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.