Andrea Jayne Martin, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

260-1-1-93-51 Issued in ND

Practice address

1110 College Dr Ste 206
Bismarck, ND 58501-1207

Phone

(701) 258-2008

Fax

(701) 223-9114

NPI assigned

Sep 16, 2006

Last updated

Jun 9, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ND

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

Specialty

Mental Health Counselor

Education

Other, 1991

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Soul Survivor Counseling Services PC

  • Mental Health Counselor
  • Bismarck, ND
  • NPI 1831502152
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1447356506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 COLLEGE DR STE 206",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011207",
            "telephone_number": "701-258-2008",
            "fax_number": "701-223-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 COLLEGE DR STE 206",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011207",
            "telephone_number": "701-258-2008",
            "fax_number": "701-223-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ANDREA",
        "middle_name": "JAYNE",
        "name_prefix": "Ms.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2021-06-09",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ND",
            "license": "260-1-1-93-51",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "260-1-1-93-51",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1463767",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karla Leann Marsh
• Camille Jean Martell
• Jeryca J Martell, BCBA
• Kara Lynn Martell
• Kevin F Martian, PHARM.D.
• Donald Christopher Martin, CRNA
• Donavin L Martin, PT
• Doug Martin
• Kent C Martin, MD
• Lori Martin

• Professional Counselor in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Professional Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.