Individual provider Active NPI

Martin Weishaar, LCPAT, LCPC

  • Counselor
  • Baltimore, MD
National Provider Identifier
1235694308
Registry record updated Dec 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LC10198 Issued in MD
Practice address
3000 Chestnut Ave Ste 202a
Baltimore, MD 21211-2727
Phone
(410) 801-9600
NPI assigned
Feb 4, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2020

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 ATC251 MD
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X LC10198 MD Primary

Addresses

Primary practice location

3000 Chestnut Ave Ste 202a
Baltimore, MD 21211-2727

Mailing address

PO Box 50031
Baltimore, MD 21211-4031
Phone (410) 801-9600

Other practice location 1

7350 Grace Drive
Columbia, MD 21044
Phone (410) 929-4592

Other practice location 2

911 W 36th St Ste 1
Baltimore, MD 21211-2445
Phone (410) 801-9600

Other identifiers 4

IdentifierTypeStateIssuer
EJ14-0000OtherMDBLUE CROSS BLUE SHIELD
60054OtherMDAETNA
589044600OtherMDMEDICAID
833319030OtherMDCIGNA

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
LC10198MDMDCounselor
ATC251MDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Insights Counseling Services, LLC. Mental Health CurrentSince Dec 22, 2020 Accepting new patients

Locations

911 W 36th St
Ste 1
Baltimore, MD 21211
Phone (410) 801-9600

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": "1549238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1235694308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50031",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212114031",
            "telephone_number": "410-801-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 CHESTNUT AVE STE 202A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212112727",
            "telephone_number": "410-801-9600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7350 Grace Drive",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "21044",
            "country_code": "US",
            "telephone_number": "410-929-4592",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "911 W 36th St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212112445",
            "country_code": "US",
            "telephone_number": "410-801-9600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEISHAAR",
        "first_name": "MARTIN",
        "credential": "LCPAT, LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-04",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "ATC251",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "MD",
            "license": "LC10198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "EJ14-0000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "60054",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "589044600",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "833319030",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; 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.