Individual provider Active NPI

Jacqueline Lissette Martinez, LMFT, LMHC, NCC

  • Mental Health Counselor
  • Coral Gables, FL
National Provider Identifier
1376242206
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH21440 Issued in FL
Practice address
4343 W Flagler St
Coral Gables, FL 33134-1586
Phone
(954) 543-0698
NPI assigned
Feb 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MT4485 FL
Mental Health Counselor 101YM0800X MH21440 FL Primary

Addresses

Primary practice location

4343 W Flagler St
Coral Gables, FL 33134-1586

Mailing address

8310 SW 114TH Ave
Miami, FL 33173-3625
Phone (305) 321-7661

Other practice location 1

9350 Sunset Dr Ste 151
Miami, FL 33173-3286
Phone (786) 548-1022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250529001900 FL Practitioner - Marriage and Family Therapist 3274052501 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH21440FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dade Family Counseling Community Mental Health Center, Inc CurrentSince May 1, 2025 Accepting new patients

Locations

9350 Sunset Dr
Ste 151
Miami, FL 33173
Phone (786) 548-1022

1951 NW 17th Ave
Miami, FL 33125
Phone (305) 265-9220

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": "1677542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1376242206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8310 SW 114TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733625",
            "telephone_number": "305-321-7661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 W FLAGLER ST",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331341586",
            "telephone_number": "954-543-0698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9350 Sunset Dr Ste 151",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331733286",
            "country_code": "US",
            "telephone_number": "786-548-1022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "JACQUELINE",
        "middle_name": "LISSETTE",
        "name_prefix": "Ms.",
        "credential": "LMFT, LMHC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-28",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT4485",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH21440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.