Active NPI
Nicole T Martin, LPCC
- Mental Health Counselor
- Cleveland, OH
National Provider Identifier
1386700730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- E0003601
- Practice address
- 1515 W 29TH St
Cleveland, OH 44113-2906 - Phone
- (216) 574-9000
- NPI assigned
- Dec 29, 2006
- 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 | E0003601 | OH | Primary |
Addresses
Primary practice location
1515 W 29TH St
Cleveland, OH 44113-2906
Mailing address
15400 Lydian Ave
Cleveland, OH 44111-3024
Phone (216) 410-1148
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
| License | State | Type | Specialty |
|---|---|---|---|
| E0003601 | OH | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192060800000",
"number": "1386700730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15400 LYDIAN AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441113024",
"telephone_number": "216-410-1148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 W 29TH ST",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441132906",
"telephone_number": "216-574-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "NICOLE",
"middle_name": "T",
"name_prefix": "Ms.",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-29",
"last_updated": "2007-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "E0003601",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.