Individual provider Active NPI

Vicki Ann Martin, LMFT

  • Marriage & Family Therapist
  • Laramie, WY
National Provider Identifier
1689853574
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
162 Issued in WY
Practice address
2404 Knoll CT
Laramie, WY 82070-8937
Phone
(307) 221-3707
Fax
(307) 742-6675
NPI assigned
Oct 29, 2007
Last updated
Jan 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 162 WY Primary

Addresses

Primary practice location

2404 Knoll CT
Laramie, WY 82070-8937

Mailing address

2404 Knoll CT
Laramie, WY 82070-8937
Phone (307) 221-3707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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

Enrollment IDStateProvider typePAC IDDetails
I20240325003825 WY Practitioner - Marriage and Family Therapist 1951748052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2020 E Grand Ave
Suite 400
Laramie, WY 82070-4388
Phone (307) 221-3707

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
162WYMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Step-by-Step Family Therapy a Professional Corporation CurrentSince Jan 3, 2012 Accepting new patients

Locations

2020 E Grand Ave
Ste 400
Laramie, WY 82070
Phone (307) 221-3707

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": "1193616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1689853574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 KNOLL CT",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820708937",
            "telephone_number": "307-221-3707",
            "fax_number": "307-742-6675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 KNOLL CT",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820708937",
            "telephone_number": "307-221-3707",
            "fax_number": "307-742-6675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "VICKI",
        "middle_name": "ANN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-29",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WY",
            "license": "162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laramie, WY

Sources for this page

Verify at the official NPI Registry.