Martha Lawson Van Dam, M.S., NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH15174 Issued in FL

Practice address

151 Mary Esther Blvd
Suite 507
Mary Esther, FL 32569-1972

Phone

(850) 226-7419

NPI assigned

Jul 31, 2014

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Living Beyond

  • Adult Mental Health Clinic/Center
  • Mary Esther, FL
  • NPI 1548912702
  NPD Authorized official
• Emerald Coast Counseling & Associates

  • Mental Health Counselor
  • Mary Esther, FL
  • NPI 1609276252
  NPD (past)

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517788800000",
    "number": "1134537301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 WINDWARD WAY",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325784328",
            "telephone_number": "850-687-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 MARY ESTHER BLVD",
            "address_2": "SUITE 507",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325691972",
            "telephone_number": "850-226-7419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DAM",
        "first_name": "MARTHA",
        "middle_name": "LAWSON",
        "name_prefix": "Mrs.",
        "credential": "M.S., NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-31",
        "last_updated": "2018-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH15174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracey L. Novak, Arnp, NP-C
• Hope D Traylor, LMT
• Jennifer M Trendt, DC
• James L Tucker, PH.D.
• Halee Tymon, BCBA
• Micheal Villanueva
• Allison E. Vinson, LCSW
• Visionworks, Inc.
• Jacqueline Elinor Watkins, RN, BSN
• Lara Watt

• Mental Health Counselor in Mary Esther, FL
• Providers in Mary Esther, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2018; 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.