Individual provider Active NPI

Alvin Willfard Martin, LPC-A

  • Professional Counselor
  • Lillington, NC
National Provider Identifier
1558840678
Registry record updated Aug 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
A14151 Issued in NC
Practice address
817 W Front St
Lillington, NC 27546-9735
Phone
(910) 814-2197
Fax
(910) 814-2167
NPI assigned
Aug 9, 2018
Last updated
Aug 9, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X A14151 NC Primary

Addresses

Primary practice location

817 W Front St
Lillington, NC 27546-9735

Mailing address

817 W Front St
Lillington, NC 27546-9735
Phone (910) 814-2197

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240130003384 NC Practitioner - Mental Health Counselor 1951754514 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A14151NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Peace of Mind, Inc. Professional CurrentSince Jan 16, 2024 Accepting new patients

Locations

817 W Front St
Lillington, NC 27546
Phone (910) 814-2197

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533772800000",
    "number": "1558840678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 W FRONT ST",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "275469735",
            "telephone_number": "910-814-2197",
            "fax_number": "910-814-2167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 W FRONT ST",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "275469735",
            "telephone_number": "910-814-2197",
            "fax_number": "910-814-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ALVIN",
        "middle_name": "WILLFARD",
        "name_prefix": "Mr.",
        "credential": "LPC-A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-09",
        "last_updated": "2018-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A14151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lillington, NC

Sources for this page

Verify at the official NPI Registry.