Active NPI
Deva Martinez, EDS
- Mental Health Counselor
- Valrico, FL
National Provider Identifier
1205003720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH15370
- Practice address
- 3405 Bloomingdale Oaks Dr
Valrico, FL 33596-6132 - Phone
- (870) 476-3437
- NPI assigned
- May 14, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1403 | AR | |
| Mental Health Counselor | 101YM0800X | P1103014 | AR | |
| Pastoral Counselor | 101YP1600X | 14152 | NC | |
| Mental Health Counselor | 101YM0800X | MH15370 | FL | Primary |
Addresses
Primary practice location
3405 Bloomingdale Oaks Dr
Valrico, FL 33596-6132
Mailing address
3405 Bloomingdale Oaks Dr
Valrico, FL 33596-6132
Phone (870) 476-3437
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1403 | AR | MD | Addiction (Substance Use Disorder) Counselor |
| P1103014 | AR | MD | Mental Health Counselor |
| MH15370 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life Strategies Counseling, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Adolescent and Children Mental Health Clinic/Center
- Paragould, AR
- NPI 1912158908
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626739200000",
"number": "1205003720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3405 BLOOMINGDALE OAKS DR",
"city": "VALRICO",
"state": "FL",
"postal_code": "335966132",
"telephone_number": "870-476-3437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3405 BLOOMINGDALE OAKS DR",
"city": "VALRICO",
"state": "FL",
"postal_code": "335966132",
"telephone_number": "870-476-3437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "DEVA",
"credential": "EDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-14",
"last_updated": "2021-07-20",
"certification_date": "2021-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "AR",
"license": "1403",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AR",
"license": "P1103014",
"primary": false
},
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "NC",
"license": "14152",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH15370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Valrico, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.