Individual provider Active NPI

Kathleen Nolde-Martin, LMHC

  • Mental Health Counselor
  • Pensacola, FL
National Provider Identifier
1396782777
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH 9464 Issued in FL
Practice address
1150 N 12TH Ave
Pensacola, FL 32501-3308
Phone
(850) 696-6431
NPI assigned
Jun 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 17680 TX
Mental Health Counselor 101YM0800X MH 9464 FL Primary
Professional Counselor 101YP2500X MH9464 FL

Addresses

Primary practice location

1150 N 12TH Ave
Pensacola, FL 32501-3308

Mailing address

1150 N 12TH Ave
Pensacola, FL 32501-3308
Phone (850) 696-6431

Other practice location 1

1221 W Lakeview Ave
Pensacola, FL 32501-1857
Phone (850) 469-3500

Other identifiers 1

IdentifierTypeStateIssuer
1567406MedicaidTX

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

LicenseStateTypeSpecialty
MH 9464FLMDMental Health Counselor
MH9464FLMDProfessional Counselor
17680TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1396782777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 N 12TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325013308",
            "telephone_number": "850-696-6431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N 12TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325013308",
            "telephone_number": "850-696-6431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1221 W Lakeview Ave",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325011857",
            "country_code": "US",
            "telephone_number": "850-469-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOLDE-MARTIN",
        "first_name": "KATHLEEN",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "17680",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 9464",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "MH9464",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1567406",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; 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.