Paul Martin, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1414 Main St
Melrose Park, IL 60160

Phone

(708) 786-8527

NPI assigned

Jan 3, 2012

Last updated

Oct 19, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Fareha N. Malik, M.D. LLCGroup PAC ID 5193863587, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Fareha N. Malik, M.D. LLC

  • Child & Adolescent Psychiatry Physician
  • Rockford, IL
  • NPI 1528195013
  Medicare reassignment Care Compare group NPD
• Emerge and See Psychonautics, PLLC

  dba Emerge and See Psychonautics

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carpentersville, IL
  • NPI 1811773757
  NPD Authorized official
• Advanced Psychiatry of Elgin

  • Behavior Analyst
  • Elgin, IL
  • NPI 1588069306
  NPD (past)

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

{
    "created_epoch": "1325548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539907200000",
    "number": "1700156171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 DOTY RD",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600987509",
            "telephone_number": "815-338-6600",
            "fax_number": "815-206-5376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 MAIN ST",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "60160",
            "telephone_number": "708-786-8527"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 W Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "McHenry",
            "state": "IL",
            "postal_code": "600508409",
            "country_code": "US",
            "telephone_number": "815-338-6600",
            "fax_number": "815-206-5376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10400 Haligus Rd",
            "address_purpose": "LOCATION",
            "city": "Huntley",
            "state": "IL",
            "postal_code": "601429553",
            "country_code": "US",
            "telephone_number": "815-338-6600",
            "fax_number": "815-206-5376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3701 Doty Rd",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "IL",
            "postal_code": "600987509",
            "country_code": "US",
            "telephone_number": "815-338-6600",
            "fax_number": "815-206-5376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-03",
        "last_updated": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie Theresa Marek, CADC
• Danya K Marou
• Daniel Marsh, LPC
• Stephanie Renee Marsh, RD, LDN
• Xavier Martillo
• Andres Rudolfo Martinez II
• Bryan Martinez
• Esther Martinez
• Jacqueline M Martinez, D.C.
• Lillian Martinez

• Mental Health Counselor in Melrose Park, IL
• Providers in Melrose Park, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2018; 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.