Individual provider Active NPI

Martin A Petersel, LMFT, LMHC

  • Marriage & Family Therapist
  • New City, NY
National Provider Identifier
1245738103
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
000322-1 Issued in NY
Practice address
3 Rexal Court
New City, NY 10956
Phone
(845) 499-2482
NPI assigned
Jan 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 001567-1 NY
Marriage & Family Therapist 106H00000X 000322-1 NY Primary

Addresses

Primary practice location

3 Rexal Court
New City, NY 10956

Mailing address

3 Rexal Court
New City, NY 10956
Phone (845) 499-2482

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
000322-1NYMDArt Therapist
001567-1NYMDArt Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Marriage and Mental Health Counseling, PC Mental Health PastSince Nov 10, 2019 Accepting new patients

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": "1516838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1245738103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 REXAL COURT",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "10956",
            "telephone_number": "845-499-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 REXAL COURT",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "10956",
            "telephone_number": "845-499-2482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEL",
        "first_name": "MARTIN",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "LMFT, LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "001567-1",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "000322-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.