Active NPI
Martha Lynn Fontenot, LAC
- Addiction (Substance Use Disorder) Counselor
- Lake Charles, LA
National Provider Identifier
1639329022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 808
- Practice address
- 614 Esplanade St
Lake Charles, LA 70607-6308 - Phone
- (337) 478-1411
- NPI assigned
- Sep 23, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 808 | LA | Primary |
Addresses
Primary practice location
614 Esplanade St
Lake Charles, LA 70607-6308
Mailing address
913 Ardmore St
Lake Charles, LA 70605-5476
Phone (337) 302-3157
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 |
|---|---|---|---|
| 808 | LA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Horizons Counseling Center, LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Mental Health Counselor
- Lake Charles, LA
- NPI 1235296906
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311897600000",
"number": "1639329022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "913 ARDMORE ST",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706055476",
"telephone_number": "337-302-3157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "614 ESPLANADE ST",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706076308",
"telephone_number": "337-478-1411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONTENOT",
"first_name": "MARTHA",
"middle_name": "LYNN",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-23",
"last_updated": "2011-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "LA",
"license": "808",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lake Charles, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.