Individual provider Active NPI

Jennifer Martin

  • Professional Counselor
  • Schaumburg, IL
National Provider Identifier
1427615301
Registry record updated Sep 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
1345 Wiley Rd Ste 124
Schaumburg, IL 60173-4356
Phone
(847) 772-7709
NPI assigned
May 25, 2019
Last updated
Sep 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

1345 Wiley Rd Ste 124
Schaumburg, IL 60173-4356

Mailing address

774 W Evergreen CT
Palatine, IL 60067-6769
Phone (847) 772-7709

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer Martin Anxiety and Ocd Services PLLC Professional CurrentSince Oct 5, 2021 Accepting new patients

Locations

1345 Wiley Rd
Ste 124
Schaumburg, IL 60173
Phone (847) 772-7709

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": "1558742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632614400000",
    "number": "1427615301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "774 W EVERGREEN CT",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600676769",
            "telephone_number": "847-772-7709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 WILEY RD STE 124",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734356",
            "telephone_number": "847-772-7709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-25",
        "last_updated": "2021-09-26",
        "certification_date": "2021-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2021; 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.