Individual provider Active NPI

Audrey Leah Martin, LCMFT

  • Marriage & Family Therapist
  • Wichita, KS
National Provider Identifier
1124268065
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
M2407002 Issued in AR
Practice address
303 N West St Ste 220
Wichita, KS 67203-1269
Phone
(316) 302-4988
NPI assigned
Mar 5, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X M2407002 AR Primary

Addresses

Primary practice location

303 N West St Ste 220
Wichita, KS 67203-1269

Mailing address

23527 Sycamore Heights Rd
Siloam Springs, AR 72761-8215
Phone (316) 644-2944

Other practice location 1

847 S Dogwood St
Siloam Springs, AR 72761-3915
Phone (316) 644-2944

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

State licenses

LicenseStateTypeSpecialty
M2407002ARMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony Springs Counseling, LLC Marriage & Family Therapist CurrentSince Sep 23, 2024 Accepting new patients
Audrey L. Martin LLC Marriage & Family Therapist CurrentSince Sep 23, 2024 Accepting new patients

Locations

847 S Dogwood St
Siloam Springs, AR 72761
Phone (316) 644-2944

303 N West St
Ste 220
Wichita, KS 67203
Phone (316) 302-4988

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1236211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1124268065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23527 SYCAMORE HEIGHTS RD",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727618215",
            "telephone_number": "316-644-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N WEST ST STE 220",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672031269",
            "telephone_number": "316-302-4988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "847 S Dogwood St",
            "address_purpose": "LOCATION",
            "city": "Siloam Springs",
            "state": "AR",
            "postal_code": "727613915",
            "country_code": "US",
            "telephone_number": "316-644-2944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "AUDREY",
        "middle_name": "LEAH",
        "credential": "LCMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-05",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AR",
            "license": "M2407002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.