Active NPI
Stacy Martin, LPC, LAC, CACI
- Professional Counselor
- Greenville, SC
National Provider Identifier
1407239585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6779
- Practice address
- 301 Halton Rd Ste F
Greenville, SC 29607-3498 - Phone
- (864) 479-4226
- NPI assigned
- Jul 7, 2015
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 454 | SC | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1802226 | SC | |
| Professional Counselor | 101YP2500X | 6779 | SC | Primary |
Addresses
Primary practice location
301 Halton Rd Ste F
Greenville, SC 29607-3498
Mailing address
301 Halton Rd Ste F
Greenville, SC 29607-3498
Phone (864) 479-4226
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 7, 2025 through May 7, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1802226 | SC | MD | Addiction (Substance Use Disorder) Counselor |
| 454 | SC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691971200000",
"number": "1407239585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 HALTON RD STE F",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296073498",
"telephone_number": "864-479-4226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 HALTON RD STE F",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296073498",
"telephone_number": "864-479-4226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "STACY",
"credential": "LPC, LAC, CACI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-07",
"last_updated": "2023-08-14",
"certification_date": "2023-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "SC",
"license": "454",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "SC",
"license": "1802226",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "SC",
"license": "6779",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.