Individual provider Active NPI

Rebecca L Martinez, LCPC

  • Mental Health Counselor
  • Bozeman, MT
National Provider Identifier
1417606492
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
56508 Issued in MT
Practice address
145 Mill Town Loop Ste B
Bozeman, MT 59718-5144
Phone
(406) 788-0478
NPI assigned
Mar 18, 2022
Last updated
Nov 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 56508 MT Primary

Addresses

Primary practice location

145 Mill Town Loop Ste B
Bozeman, MT 59718-5144

Mailing address

108 Indian Grove LN
Bozeman, MT 59718-8252
Phone (406) 788-0478

Other practice location 1

2246 Boot Hill Ct # 3
Bozeman, MT 59715-7248
Phone (406) 579-4984

Other identifiers 1

IdentifierTypeStateIssuer
236MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20240613004232 MT Practitioner - Mental Health Counselor 5395288757 Practice locations: Bozeman, MT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
56508MTMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1417606492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 INDIAN GROVE LN",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597188252",
            "telephone_number": "406-788-0478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 MILL TOWN LOOP STE B",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597185144",
            "telephone_number": "406-788-0478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2246 Boot Hill Ct # 3",
            "address_purpose": "LOCATION",
            "city": "Bozeman",
            "state": "MT",
            "postal_code": "597157248",
            "country_code": "US",
            "telephone_number": "406-579-4984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "REBECCA",
        "middle_name": "L",
        "name_prefix": "Miss",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-18",
        "last_updated": "2022-11-30",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MT",
            "license": "56508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "236",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

Verify at the official NPI Registry.