Individual provider Active NPI

Carrie Lynn Martinez, LPC

  • Mental Health Counselor
  • Shoreline, WA
National Provider Identifier
1467960823
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH61502897 Issued in WA
Practice address
1201 N 175TH St
Shoreline, WA 98133-5064
Phone
(425) 339-5453
Fax
(425) 252-4441
NPI assigned
Jan 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 66326 TX
Mental Health Counselor 101YM0800X LH61502897 WA Primary

Addresses

Primary practice location

1201 N 175TH St
Shoreline, WA 98133-5064

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (425) 304-8431

Other practice location 1

12340 Jones Rd Ste 290
Houston, TX 77070-3129
Phone (281) 894-7222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240401000252 WA Practitioner - Mental Health Counselor 8426496100 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

1201 N 175TH St
Shoreline, WA 98133-5064
Phone (425) 339-4299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
66326TXMDMental Health Counselor
LH61502897WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC CurrentSince Mar 2, 2024 Accepting new patients
The Polyclinic PLLC CurrentSince Feb 26, 2024 Accepting new patients
The Polyclinic PLLC CurrentSince Feb 26, 2024 Accepting new patients
Optum Care Washington PLLC CurrentSince Mar 2, 2024 Accepting new patients

Locations

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

9709 3rd Ave NE
Seattle, WA 98115
Phone (206) 525-5777

1145 Broadway
Seattle, WA 98122

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Organizations & group practices 4

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": "1516233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1467960823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "425-304-8431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N 175TH ST",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981335064",
            "telephone_number": "425-339-5453",
            "fax_number": "425-252-4441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12340 Jones Rd Ste 290",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770703129",
            "country_code": "US",
            "telephone_number": "281-894-7222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "CARRIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-18",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "66326",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61502897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

Verify at the official NPI Registry.