Nicole L Martin, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

6915 Crumpler Blvd Ste a
Olive Branch, MS 38654-1907

Phone

(601) 500-1132

NPI assigned

Nov 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1194906396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6915 CRUMPLER BLVD STE A",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386541907",
            "telephone_number": "601-500-1132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6915 CRUMPLER BLVD STE A",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386541907",
            "telephone_number": "601-500-1132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "NICOLE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-16",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "nicolemartincounseling.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6915 Crumpler Blvd Ste A",
            "city": "Olive Branch",
            "state": "MS",
            "country_code": "US",
            "postal_code": "386541907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shanna Jade Manning, DPT
• Margo D Ray Inc
• Christopher Scott Markham, LPT
• Carla Arnette Martin, D.P.M.
• Madelon Sullivan Martin, LPC, RPT
• Shawna Lee Martin, AGPCNP-BC
• Briana Cymone Mason, PHARMD
• Masterpiece Counseling and Health Services, PLLC
• Erica Mathis, DDS
• Stacey Leigh Mathis, MS,CCC-SLP

• Mental Health Counselor in Olive Branch, MS
• Providers in Olive Branch, MS by specialty
• Mental Health Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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.