Tristan Karel Martin, PH.D.,LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

001640 Issued in NY

Practice address

4500 Pewter Lane
8&9
Manlius, NY 13104

Phone

(315) 299-6975

NPI assigned

Oct 20, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1539993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1275009995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "792 N MAIN ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132121644",
            "telephone_number": "315-299-6975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 PEWTER LANE",
            "address_2": "8&9",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "13104",
            "telephone_number": "315-299-6975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "TRISTAN",
        "middle_name": "KAREL",
        "name_prefix": "Dr.",
        "credential": "PH.D.,LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-20",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "P10033",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "001640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breyanna Marie Locke, M.S., M.A.,LMFT
• Meghan Lounsbury, DPT
• Aimee Lynn Macblane, LMSW
• Brandon Robert Magill, D.M.D
• Stephanie Marshall
• Gabrielle Mari Masse, FNP-C
• Kirsten Mathieson
• Tyler Maxon, O.D.
• Lori McCrohan
• Mary Ann McDonald, MS

• Marriage & Family Therapist in Manlius, NY
• Providers in Manlius, NY by specialty
• Marriage & Family Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.