Individual provider Active NPI

Martinique Coffey

  • Addiction (Substance Use Disorder) Counselor
  • Jeffersonville, IN
National Provider Identifier
1225906332
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
34012200A Issued in IN
Practice address
101 Noahs LN
Jeffersonville, IN 47130-5380
Phone
(812) 288-6800
Fax
(812) 288-6800
NPI assigned
Oct 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 34012200A IN
Clinical Social Worker 1041C0700X 34012200A IN
Addiction (Substance Use Disorder) Counselor 101YA0400X 34012200A IN Primary

Addresses

Primary practice location

101 Noahs LN
Jeffersonville, IN 47130-5380

Mailing address

101 Noahs LN
Jeffersonville, IN 47130-5380
Phone (812) 288-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20260428000399 IN Practitioner - Clinical Social Worker 3577030568

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

460 Spring St
Jeffersonville, IN 47130-3452

460 Spring St
Jeffersonville, IN 47130-3499

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34012200AINMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Ark, Inc. CurrentSince Nov 8, 2025 Accepting new patients

Locations

101 Noahs Ln
Jeffersonville, IN 47130
Phone (812) 282-8479

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.

NPI Registry JSON

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

{
    "created_epoch": "1761696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1225906332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NOAHS LN",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471305380",
            "telephone_number": "812-288-6800",
            "fax_number": "812-288-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NOAHS LN",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471305380",
            "telephone_number": "812-288-6800",
            "fax_number": "812-288-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFEY",
        "first_name": "MARTINIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-29",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "34012200A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34012200A",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "34012200A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

Verify at the official NPI Registry.