Individual provider Active NPI

Connie J Martin, L.P.C.

  • Professional Counselor
  • Shreveport, LA
National Provider Identifier
1255760534
Registry record updated Nov 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3888 Issued in LA
Practice address
1310 N Hearne Ave
Room 223
Shreveport, LA 71107-6516
Phone
(318) 676-5131
NPI assigned
Nov 6, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3888 LA Primary

Addresses

Primary practice location

1310 N Hearne Ave
Room 223
Shreveport, LA 71107-6516

Mailing address

1310 N Hearne Ave
Room 223
Shreveport, LA 71107-6516
Phone (318) 676-5131

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
3888LAMDProfessional Counselor

Interoperability endpoints

  • Direct secure messaging: conniesallin@nlhsd.direct.kno2fy.com

NPI Registry JSON

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

{
    "created_epoch": "1383696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1255760534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 N HEARNE AVE",
            "address_2": "ROOM 223",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711076516",
            "telephone_number": "318-676-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 N HEARNE AVE",
            "address_2": "ROOM 223",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711076516",
            "telephone_number": "318-676-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CONNIE",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-06",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "3888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; 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.