NPIMap

Organization Active NPI

Mary Martin

  • Clinic/Center
  • Kingston, PA
National Provider Identifier
1548552292
Registry record updated Mar 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
CW014765 Issued in PA
Legal business name
MARY MARTIN
Practice address
400 3Rd Ave
Suite 308
Kingston, PA 18704-5816
Phone
(570) 417-2830
NPI assigned
May 12, 2011
Last updated
Mar 28, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2013

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

Authorized official

Name
Mary MartinNPI 1275654642
Title
LCSW
Phone
(570) 417-2830

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X CW014765 PA Primary

Addresses

Primary practice location

400 3Rd Ave
Suite 308
Kingston, PA 18704-5816

Mailing address

PO Box 1388
Kingston, PA 18704-0388
Phone (570) 288-8881

Other names 1

  • Mary Martin Counseling Services LLC Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364428800000",
    "number": "1548552292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1388",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187040388",
            "telephone_number": "570-288-8881",
            "fax_number": "570-288-8065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 3RD AVE",
            "address_2": "SUITE 308",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045816",
            "telephone_number": "570-417-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY MARTIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-12",
        "last_updated": "2013-03-28",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "LCSW",
        "authorized_official_telephone_number": "570-417-2830"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PA",
            "license": "CW014765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mary Martin Counseling Services LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kingston, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.