Individual provider Active NPI

Jennifer Orta Martinez, QTT

  • Counselor
  • Milwaukee, WI
National Provider Identifier
1417536152
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
APPLIED Issued in WI
Practice address
1635 W National Ave
Milwaukee, WI 53204-1130
Phone
(414) 672-1353
NPI assigned
Apr 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychoanalyst 102L00000X
Counselor 101Y00000X APPLIED WI Primary

Addresses

Primary practice location

1635 W National Ave
Milwaukee, WI 53204-1130

Mailing address

PO Box 778789
Chicago, IL 60677-8789
Phone (414) 672-1353

Other practice location 1

2906 S 20th St
Milwaukee, WI 53215-3732
Phone (414) 672-1353

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
APPLIEDWIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sixteenth Street Community Health Centers, Inc. Past Accepting new patients

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": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1417536152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 778789",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606778789",
            "telephone_number": "414-672-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 W NATIONAL AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532041130",
            "telephone_number": "414-672-1353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2906 S 20th St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532153732",
            "country_code": "US",
            "telephone_number": "414-672-1353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "JENNIFER",
        "middle_name": "ORTA",
        "credential": "QTT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WI",
            "license": "APPLIED",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.