Active NPI
Amanda Martin, LMHC 19749
- Mental Health Counselor
- Maitland, FL
National Provider Identifier
1508538034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH19749
- Practice address
- 711 N Orlando Ave Ste. 203
Maitland, FL 32751 - Phone
- (407) 406-4885
- NPI assigned
- Oct 3, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH19749 | FL | Primary |
Addresses
Primary practice location
711 N Orlando Ave Ste. 203
Maitland, FL 32751
Mailing address
551 Cidermill Place
Lake Mary, FL 32746
Phone (407) 406-4885
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 |
|---|---|---|---|
| MH19749 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633219200000",
"number": "1508538034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "551 CIDERMILL PLACE",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "32746",
"telephone_number": "407-406-4885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 N ORLANDO AVE STE. 203",
"city": "MAITLAND",
"state": "FL",
"postal_code": "32751",
"telephone_number": "407-406-4885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "AMANDA",
"credential": "LMHC 19749",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-03",
"last_updated": "2021-10-03",
"certification_date": "2021-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH19749",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maitland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.