Individual provider Active NPI

Lindsay Nicole Martinez, PSY.D.

  • Clinical Psychologist
  • Gate City, VA
National Provider Identifier
1235489634
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
081005796 Issued in VA
Practice address
190 Beech Street
Suite 102
Gate City, VA 24251-3600
Phone
(276) 386-3803
Fax
(276) 386-2116
NPI assigned
Sep 12, 2012
Last updated
Apr 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 081005796 VA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

190 Beech Street
Suite 102
Gate City, VA 24251-3600

Mailing address

508 E. Unaka Avenue
Johnson City, TN 37601
Phone (276) 328-8012

Other practice location 1

1006 US Highway 23 North
Weber City, VA 24290-7021
Phone (276) 225-0976

Other names 1

  • Lindsay Nicole Castillo-Martinez Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
081005796VAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1235489634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 E. UNAKA AVENUE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37601",
            "telephone_number": "276-328-8012",
            "fax_number": "276-386-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 BEECH STREET",
            "address_2": "SUITE 102",
            "city": "GATE CITY",
            "state": "VA",
            "postal_code": "242513600",
            "telephone_number": "276-386-3803",
            "fax_number": "276-386-2116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1006 US Highway 23 North",
            "address_purpose": "LOCATION",
            "city": "Weber City",
            "state": "VA",
            "postal_code": "242907021",
            "country_code": "US",
            "telephone_number": "276-225-0976",
            "fax_number": "423-467-3644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "LINDSAY",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-12",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "081005796",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSAY",
            "last_name": "CASTILLO-MARTINEZ",
            "middle_name": "NICOLE",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gate City, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.