Melissa Martin, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.012812 Issued in IL

Practice address

2428 N Western Ave
Chicago, IL 60647-2012

Phone

(773) 329-0636

NPI assigned

Sep 22, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Martin Psychotherapy

  • Mental Health Counselor
  • Arlington Heights, IL
  • NPI 1467255521
  NPD Authorized official
• The Renfrew Center of Illinois

  • Professional Counselor
  • Northbrook, IL
  • NPI 1275058745
  NPD (past) Authorized official
• The Renfrew Centers, Inc.

  • Adult Mental Health Clinic/Center
  • Northbrook, IL
  • NPI 1811398803
  NPD (past)

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

{
    "created_epoch": "1506038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1174032007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1057 PONCA DR",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605101145",
            "telephone_number": "773-329-0636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2428 N WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472012",
            "telephone_number": "773-329-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MELISSA",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-22",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.012613",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.012812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GOLDEN RULE- A UNITED HEALTHCARE COMPANY",
            "identifier": "094307603",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maritza Martin
• Marlon Martin Jr.
• Mary Martin
• Matthew Martin, PHD
• May Martin, FNP BC
• Molly A Martin, M.D.
• Narisse Martin
• Nicole Martin, MS, LCPC
• Paul Martin, M.D.
• Paul Michael Martin, PSYD

• Professional Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Professional Counselor in Illinois

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