Active NPI
Jessica Martin, MA, LPC
- Mental Health Counselor
- San Antonio, TX
National Provider Identifier
1336674696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 71058
- Practice address
- 4522 Fredericksburg Rd
San Antonio, TX 78201-6521 - Phone
- (210) 732-1802
- NPI assigned
- Apr 25, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 71058 | TX | Primary |
Addresses
Primary practice location
4522 Fredericksburg Rd
San Antonio, TX 78201-6521
Mailing address
4522 Fredericksburg Rd
San Antonio, TX 78201-6521
Phone (210) 732-1802
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71058 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493078400000",
"number": "1336674696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4522 FREDERICKSBURG RD",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782016521",
"telephone_number": "210-732-1802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4522 FREDERICKSBURG RD",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782016521",
"telephone_number": "210-732-1802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "JESSICA",
"credential": "MA, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-25",
"last_updated": "2017-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "71058",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.