Individual provider Active NPI

Lynn Ruth Martin, LCMHC

  • Mental Health Counselor
  • Burlington, VT
National Provider Identifier
1205335130
Registry record updated Mar 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
068.0102645 Issued in VT
Practice address
130 Mansfield Ave Apt 201
Burlington, VT 05401-3396
Phone
(802) 448-3954
NPI assigned
Feb 6, 2018
Last updated
Mar 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2018

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 1997 MA
Mental Health Counselor 101YM0800X 068.0102645 VT Primary

Addresses

Primary practice location

130 Mansfield Ave Apt 201
Burlington, VT 05401-3396

Mailing address

130 Mansfield Ave Apt 201
Burlington, VT 05401-3396
Phone (802) 448-3954

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260202003155 VT Practitioner - Mental Health Counselor 6406208479 Practice locations: Burlington, VT

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

130 Mansfield Ave
Apt 201
Burlington, VT 05401-3394

86 Saint Paul St
Suite 206
Burlington, VT 05401-4958
Phone (802) 324-6746

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
068.0102645VTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Distancetherapy.Com Mental Health CurrentSince Jul 21, 2014 Accepting new patients
Distancetherapy.Com Mental Health Past Accepting new patients

Locations

86 Saint Paul St
Ste 206
Burlington, VT 05401
Phone (802) 324-6746

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1517875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521158400000",
    "number": "1205335130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 MANSFIELD AVE APT 201",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054013396",
            "telephone_number": "802-448-3954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 MANSFIELD AVE APT 201",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054013396",
            "telephone_number": "802-448-3954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LYNN",
        "middle_name": "RUTH",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-06",
        "last_updated": "2018-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "1997",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "068.0102645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.