Paula Shane Martin, MS,LSW,LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

39001302A Issued in IN

Practice address

909 E State Blvd
Fort Wayne, IN 46807-3513

Phone

(260) 481-2700

NPI assigned

May 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Paula S.Caruthers Martin Other name

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Mental Health Counselor

Education

Other, 1998

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Cross Connections, Inc

  • Mental Health Counselor
  • Fort Wayne, IN
  • NPI 1285112060
  Medicare reassignment
• Uniquely You Counseling and Wellness Center, LLC

  • Mental Health Counselor
  • Fort Wayne, IN
  • NPI 1629765284
  NPD (past)

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258934400000",
    "number": "1649480625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468053404",
            "telephone_number": "260-481-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468073513",
            "telephone_number": "260-481-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "PAULA",
        "middle_name": "SHANE",
        "name_prefix": "Ms.",
        "credential": "MS,LSW,LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2009-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39001302A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAULA",
            "last_name": "MARTIN",
            "middle_name": "S.CARUTHERS",
            "prefix": "MS.",
            "credential": "MS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Harrison Martin
• Jorden Martin
• Kamora Mary Alice Martin
• Mia Martin
• Monique Martin, RBT
• Rebecca M Martin, D.O.
• Sarah Martin, MOT, OTR
• Scott E Martin, O.D.
• Shannon Martin, CFNC
• Tara Martin, PTA

• Mental Health Counselor in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2009; 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.

Verify at the official NPI Registry.