Active NPI
Tracy Martin, MA, TCAC
- Addiction (Substance Use Disorder) Counselor
- Cheverly, MD
National Provider Identifier
1689081044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- AOD - TRAINEE
- Practice address
- 3003 Hospital Dr
Groud Floor
Cheverly, MD 20785-1194 - Phone
- (301) 583-5935
- Fax
- (301) 583-5942
- NPI assigned
- Jul 17, 2014
- 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 | AOD - TRAINEE | MD | Primary |
Addresses
Primary practice location
3003 Hospital Dr
Groud Floor
Cheverly, MD 20785-1194
Mailing address
3003 Hospital Dr
Groud Floor
Cheverly, MD 20785-1194
Phone (301) 583-5935
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 |
|---|---|---|---|
| AOD - TRAINEE | MD | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405555200000",
"number": "1689081044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3003 HOSPITAL DR",
"address_2": "GROUD FLOOR",
"city": "CHEVERLY",
"state": "MD",
"postal_code": "207851194",
"telephone_number": "301-583-5935",
"fax_number": "301-583-5942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3003 HOSPITAL DR",
"address_2": "GROUD FLOOR",
"city": "CHEVERLY",
"state": "MD",
"postal_code": "207851194",
"telephone_number": "301-583-5935",
"fax_number": "301-583-5942"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "TRACY",
"name_prefix": "Mrs.",
"credential": "MA, TCAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-17",
"last_updated": "2014-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MD",
"license": "AOD - TRAINEE",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cheverly, MD
- Sunita Rao Mandava, M.D.,
- Geetha Sagar Manikonda, M.D.
- David Anthony Mann, MS PT
- Tiffany Altamaria Mapp, D.O.
- Margaret E Akpan, MD PA
- Maryland CVS Pharmacy, L.L.C. (CVS Pharmacy# 01489)
- Maryland Emergency Medicine Network Physicians, LLC
- Maryland Treatment Centers, Inc (Mountain Manor- Safe Passages)
- Maryland Treatment Centers, Inc. (Safe Passages)
- James Maseno, HOME HEALTH AIDE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.