Active NPI
Jeffrey Steven Martin, PHD
- Counseling Psychologist
- Charlotte, VT
National Provider Identifier
1508281064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 0480000491
- Practice address
- 300 Palmer LN
Charlotte, VT 05445-4410 - Phone
- (802) 425-4319
- NPI assigned
- Feb 20, 2014
- Last updated
- Feb 20, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 0480000491 | VT | Primary |
Addresses
Primary practice location
300 Palmer LN
Charlotte, VT 05445-4410
Mailing address
300 Palmer LN
Charlotte, VT 05445-4410
Phone (802) 425-4319
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0480000491 | VT | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392854400000",
"number": "1508281064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 PALMER LN",
"city": "CHARLOTTE",
"state": "VT",
"postal_code": "054454410",
"telephone_number": "802-425-4319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 PALMER LN",
"city": "CHARLOTTE",
"state": "VT",
"postal_code": "054454410",
"telephone_number": "802-425-4319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "JEFFREY",
"middle_name": "STEVEN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-02-20",
"last_updated": "2014-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "VT",
"license": "0480000491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.