Individual provider Active NPI

Aileen Martinez

  • Mental Health Counselor
  • Central Islip, NY
National Provider Identifier
1396410734
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
320 Carleton Ave
Central Islip, NY 11722-4506
Phone
(631) 663-4300
NPI assigned
Aug 9, 2021
Last updated
Aug 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

320 Carleton Ave
Central Islip, NY 11722-4506

Mailing address

790 Park Ave
Huntington, NY 11743-4516
Phone (631) 427-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250328000319 NY Practitioner - Mental Health Counselor 5496278673 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service League, Inc. CurrentSince Jan 16, 2025 Accepting new patients

Locations

320 Carleton Ave
Central Islip, NY 11722
Phone (631) 234-7807

790 Park Ave
Huntington, NY 11743
Phone (631) 427-3700

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1396410734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 PARK AVE",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117434516",
            "telephone_number": "631-427-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 CARLETON AVE",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117224506",
            "telephone_number": "631-663-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "AILEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-09",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Central Islip, NY

Sources for this page

Verify at the official NPI Registry.