Individual provider Active NPI

Jon Sebastian Martinez

  • Mental Health Counselor
  • Green Bay, WI
National Provider Identifier
1144930868
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11318125 Issued in WI
Practice address
610 N Broadway
Green Bay, WI 54303-3426
Phone
(956) 206-1130
NPI assigned
Dec 5, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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 11318125 WI Primary
Mental Health Counselor 101YM0800X 87416 TX

Addresses

Primary practice location

610 N Broadway
Green Bay, WI 54303-3426

Mailing address

1686 Birchwood Dr
Green Bay, WI 54304-2937
Phone (956) 206-1130

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
87416TXMDMental Health Counselor
11318125WIMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1144930868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1686 BIRCHWOOD DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543042937",
            "telephone_number": "956-206-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 N BROADWAY",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033426",
            "telephone_number": "956-206-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "JON",
        "middle_name": "SEBASTIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-05",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "11318125",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "87416",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; 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.