Kristin Anne Martin, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

073985 Issued in IA

Practice address

312 Iowa Ave
Muscatine, IA 52761-3836

Phone

(563) 320-7050

Fax

(563) 424-5453

NPI assigned

Dec 2, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Kristin Anne Wallace Former name

Medicare fee-for-service enrollment

Enrolled in IA

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

Medicare enrollment (NPD)

Enrolled

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.

• Heal & Thrive LLC

  • Mental Health Counselor
  • Letts, IA
  • NPI 1972462190
  NPD Authorized official
• Family Empowerment Services, Inc

  • Social Worker
  • Davenport, IA
  • NPI 1093942856
  Medicare reassignment

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1679110217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14640 BUTTERCUP LN",
            "city": "LETTS",
            "state": "IA",
            "postal_code": "527549311",
            "telephone_number": "563-554-4821",
            "fax_number": "563-454-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 IOWA AVE",
            "city": "MUSCATINE",
            "state": "IA",
            "postal_code": "527613836",
            "telephone_number": "563-320-7050",
            "fax_number": "563-424-5453"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1706 Brady St Ste 206",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "IA",
            "postal_code": "528034708",
            "country_code": "US",
            "telephone_number": "563-320-7050",
            "fax_number": "563-424-5453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KRISTIN",
        "middle_name": "ANNE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-02",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "073985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "WALLACE",
            "middle_name": "ANNE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Magnolia Home Care, LLC
• Allison Mann, PA-C
• Fabiola Ioana Manyi-Orellana
• Sage Marske
• Katie Martin
• Mark E Mather, OD
• Kirsten Corin Maxwell, ARNP
• Richard Maynard, CRNA
• Cole McClary
• Kathleen McDaniel-Shaman, BA

• Mental Health Counselor in Muscatine, IA
• Providers in Muscatine, IA by specialty
• Mental Health Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.