Nicole S Martin, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2069 Issued in WV

Practice address

505 28TH St
Vienna, WV 26105-1451

Phone

(304) 295-4484

NPI assigned

Jan 15, 2014

Sex

Female

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

State licenses

Practice roles

Locations

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.

• Evergreen Counseling and Yoga Therapy

  • Mental Health Counselor
  • Vienna, WV
  • NPI 1033814058
  NPD Authorized official

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549584000000",
    "number": "1356763080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 28TH ST",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261051451",
            "telephone_number": "304-295-4484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 28TH ST",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261051451",
            "telephone_number": "304-295-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "NICOLE",
        "middle_name": "S",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-15",
        "last_updated": "2019-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WV",
            "license": "12-305",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "2069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara Marsh
• Ashton Marshall
• Ray Marshall
• Crystal Martin
• Gregory Wayne Martin, R.PH.
• Daveanna Joella Masters
• Veronique Mathaux
• Evan F Matheny, BS
• Joshua McAulty
• Carl S McCale, D.C.

• Professional Counselor in Vienna, WV
• Providers in Vienna, WV by specialty
• Professional Counselor in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2019; 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.