Active NPI
Nallely Martinez, MS
- Professional Counselor
- Mission, TX
National Provider Identifier
1114665668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 81508
- Practice address
- 1408 Thompson Rd
Mission, TX 78573-0301 - Phone
- (956) 984-9593
- NPI assigned
- May 24, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 15313 | TX | |
| Professional Counselor | 101YP2500X | 81508 | TX | Primary |
Addresses
Primary practice location
1408 Thompson Rd
Mission, TX 78573-0301
Mailing address
1408 Thompson Rd
Mission, TX 78573-0301
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 22, 2024 through Feb 22, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 81508 | TX | MD | Professional Counselor |
| 15313 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653350400000",
"number": "1114665668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1408 THOMPSON RD",
"city": "MISSION",
"state": "TX",
"postal_code": "785730301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1408 THOMPSON RD",
"city": "MISSION",
"state": "TX",
"postal_code": "785730301",
"telephone_number": "956-984-9593"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "NALLELY",
"credential": "MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-24",
"last_updated": "2022-05-24",
"certification_date": "2022-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "15313",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "81508",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mission, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.