Individual provider Active NPI

Timothy Joseph Martin, LLPC

  • Addiction (Substance Use Disorder) Counselor
  • Waterford, MI
National Provider Identifier
1700616398
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
6451023709 Issued in MI
Practice address
1255 N Oakland Blvd
Waterford, MI 48327-1545
Phone
(248) 406-0090
NPI assigned
Aug 7, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 6451023709 MI Primary

Addresses

Primary practice location

1255 N Oakland Blvd
Waterford, MI 48327-1545

Mailing address

1255 N Oakland Blvd
Waterford, MI 48327-1545
Phone (248) 406-0090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1255 N Oakland Blvd
Waterford, MI 48327-1545

6149 Gordon Rd
Waterford, MI 48327-1740

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6451023709MIMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1722988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1700616398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 N OAKLAND BLVD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271545",
            "telephone_number": "248-406-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 N OAKLAND BLVD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271545",
            "telephone_number": "248-406-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "TIMOTHY",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "LLPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-07",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "6451023709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

Verify at the official NPI Registry.