Martin Wynn Phillips, L.P.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701001549 Issued in VA

Practice address

411 Cedar Rd
Chesapeake, VA 23322-5566

Phone

(757) 548-8848

NPI assigned

Sep 28, 2006

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 VA

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, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tidewater Pastoral Counseling Services, IncGroup PAC ID 3072772268, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Tidewater Pastoral Counseling Services, Inc

  • Pastoral Counselor
  • Norfolk, VA
  • NPI 1407014509
  Medicare reassignment Care Compare group NPD Authorized official
• Psychological Services of Chesapeake, P.C.

  • Clinical Psychologist
  • Chesapeake, VA
  • NPI 1669487088
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1720179146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 CEDAR RD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233225566",
            "telephone_number": "757-548-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 CEDAR RD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233225566",
            "telephone_number": "757-548-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MARTIN",
        "middle_name": "WYNN",
        "name_prefix": "Mr.",
        "credential": "L.P.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701001549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelica Phillips
• Ashley M Phillips
• Huben Lindale Phillips, IDC
• Lisa Owens Phillips, MS, OTR/L
• Mario Delano Phillips Jr., IDC
• Physiatry-Sports & Family Medicine, LLC
• John G Piacenti, DPM
• Frank Joseph Piccioni, D.O.
• Janelle Voight Pickering, DNP, CRNA
• Rajeev Koipurath Pillai, MD

• Professional Counselor in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.