Active NPI
Jill Martin, MA, LLPC, CAAC
- Addiction (Substance Use Disorder) Counselor
- Farmington Hills, MI
National Provider Identifier
1588987465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- C-00413
- Practice address
- 31993 W 12 Mile Rd
311
Farmington Hills, MI 48334-3630 - Phone
- (248) 854-5158
- NPI assigned
- Mar 8, 2010
- Last updated
- Aug 30, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6401010625 | MI | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | C-00413 | MI | Primary |
Addresses
Primary practice location
31993 W 12 Mile Rd
311
Farmington Hills, MI 48334-3630
Mailing address
31993 W 12 Mile Rd
311
Farmington Hills, MI 48334-3630
Phone (248) 854-5158
Other names 1
- Jill Costello
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pcerecords.essmichigan@direct.mihin.net | Easterseals MORC Health Care, Inc. |
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401010625 | MI | MD | Counselor |
| C-00413 | MI | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661817600000",
"number": "1588987465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31993 W 12 MILE RD",
"address_2": "311",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483343630",
"telephone_number": "248-854-5158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31993 W 12 MILE RD",
"address_2": "311",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483343630",
"telephone_number": "248-854-5158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "JILL",
"credential": "MA, LLPC, CAAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-08",
"last_updated": "2022-08-30",
"certification_date": "2022-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "6401010625",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MI",
"license": "C-00413",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "pcerecords.essmichigan@direct.mihin.net",
"affiliation": "Y",
"affiliationName": "Easterseals MORC Health Care, Inc.",
"address_1": "2399 E Walton Blvd",
"city": "Auburn Hills",
"state": "MI",
"country_code": "US",
"postal_code": "483261955",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "JILL",
"last_name": "COSTELLO",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.