Individual provider Active NPI

Ebony Martinez, LCMHC-A

  • Mental Health Counselor
  • Mooresville, NC
National Provider Identifier
1235656521
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A16830 Issued in NC
Practice address
516 River Hwy Ste D246
Mooresville, NC 28117-7808
Phone
(704) 228-6103
Fax
(704) 368-1916
NPI assigned
Aug 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X QASP-S9012 GA
Behavior Analyst 103K00000X RBT-16-20302 GA
Mental Health Counselor 101YM0800X A16830 NC Primary

Addresses

Primary practice location

516 River Hwy Ste D246
Mooresville, NC 28117-7808

Mailing address

516 River Hwy Ste D246
Mooresville, NC 28117-7808
Phone (704) 228-6103

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL admin@calmcounseledthoughts.com Direct Calm. Counseled. Thoughts., PLLC
CONNECT URL admin@calmcounseledthoughts.com Health Information Exchange (HIE) Calm. Counseled. Thoughts., PLLC

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

LicenseStateTypeSpecialty
A16830NCMDMental Health Counselor
QASP-S9012GAMDBehavioral Analyst
RBT-16-20302GAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Calm. Counseled. Thoughts., PLLC Mental Health CurrentSince Dec 5, 2021 Accepting new patients
Compass Behavioral & Developmental Consultants LLC Behavior Analyst Past Accepting new patients

Locations

516 River Hwy
Ste D246
Mooresville, NC 28117
Phone (704) 228-6103

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1503878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1235656521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 RIVER HWY STE D246",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281177808",
            "telephone_number": "704-228-6103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 RIVER HWY STE D246",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281177808",
            "telephone_number": "704-228-6103",
            "fax_number": "704-368-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "EBONY",
        "credential": "LCMHC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-28",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": "QASP-S9012",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": "RBT-16-20302",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A16830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "admin@calmcounseledthoughts.com",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "Calm. Counseled. Thoughts., PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "516 River Hwy Ste D246",
            "city": "Mooresville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281177808",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "admin@calmcounseledthoughts.com",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "Calm. Counseled. Thoughts., PLLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "516 River Hwy Ste D246",
            "city": "Mooresville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281177808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.

Verify at the official NPI Registry.