Andrew Lee Martin, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6742 Issued in OH

Practice address

9 Charlton St
Princeton, NJ 08540

Phone

(609) 454-3214

Fax

(609) 250-7108

NPI assigned

Dec 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2024 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Resources for Healthy Living Inc

  • Psychologist
  • Perrysburg, OH
  • NPI 1992898829
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1164590923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CHARLTON ST",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085405231",
            "telephone_number": "609-454-3214",
            "fax_number": "609-250-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 CHARLTON ST",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "08540",
            "telephone_number": "609-454-3214",
            "fax_number": "609-250-7108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 Louisiana Ave",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Perrysburg",
            "state": "OH",
            "postal_code": "435511470",
            "country_code": "US",
            "telephone_number": "419-874-9488",
            "fax_number": "419-874-4822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ANDREW",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "03841",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "6742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405146700",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "77260044",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "64161101",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yana Markidan, MD
• Melissa Marks, M.D.
• Jennifer Marshall, MA, LAC
• Rebecca G. Marshall, M.D.
• Jaclyn Martelli
• Robert A Martin, M.D.
• Victoria Martin, LCSW
• Charles F Martinson, MD
• Elizabeth Anna Maslowska, LPC, ATR-BC
• Lauren Matos

• Clinical Psychologist in Princeton, NJ
• Providers in Princeton, NJ by specialty
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; 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.

Verify at the official NPI Registry.