Active NPI
Michael Anthony Martinez, MSW, LSW
- Mental Health Counselor
- Aurora, IL
National Provider Identifier
1508357401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 150.103008
- Practice address
- 1630 Plum St
Aurora, IL 60506-3462 - Phone
- (630) 892-0027
- NPI assigned
- May 25, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 150.103008 | IL | Primary |
Addresses
Primary practice location
1630 Plum St
Aurora, IL 60506-3462
Mailing address
1630 Plum St
Aurora, IL 60506-3462
Phone (630) 892-0027
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150.103008 | IL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527206400000",
"number": "1508357401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1630 PLUM ST",
"city": "AURORA",
"state": "IL",
"postal_code": "605063462",
"telephone_number": "630-892-0027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1630 PLUM ST",
"city": "AURORA",
"state": "IL",
"postal_code": "605063462",
"telephone_number": "630-892-0027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "MICHAEL",
"middle_name": "ANTHONY",
"credential": "MSW, LSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-25",
"last_updated": "2018-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "150.103008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.