Active NPI
Jeannie Martinez
- Professional Counselor
- Fort Worth, TX
National Provider Identifier
1609318542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 70909
- Practice address
- 4420 W Vickery Blvd Ste 103B
Fort Worth, TX 76107-6259 - Phone
- (682) 443-5379
- NPI assigned
- Nov 9, 2016
- Last updated
- Feb 27, 2026
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 70909 | TX | Primary |
Addresses
Primary practice location
4420 W Vickery Blvd Ste 103B
Fort Worth, TX 76107-6259
Mailing address
3713 Ashland Ave
Fort Worth, TX 76107-6210
Phone (325) 829-7649
Other practice location 1
3713 Ashland Ave
Fort Worth, TX 76107-6210
Phone (325) 829-7649
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2011
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Dallas, TX 75373
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70909 | TX | MD | Pharmacist |
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": "1478649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772150400000",
"number": "1609318542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3713 ASHLAND AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761076210",
"telephone_number": "325-829-7649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4420 W VICKERY BLVD STE 103B",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761076259",
"telephone_number": "682-443-5379"
}
],
"practiceLocations": [
{
"address_1": "3713 Ashland Ave",
"address_purpose": "LOCATION",
"city": "Fort Worth",
"state": "TX",
"postal_code": "761076210",
"country_code": "US",
"telephone_number": "325-829-7649",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARTINEZ",
"first_name": "JEANNIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-11-09",
"last_updated": "2026-02-27",
"certification_date": "2026-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "70909",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.