Stephen Martin, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS004221L Issued in PA

Practice address

119 Coulter Ave
Ardmore, PA 19003-2427

Phone

(610) 896-7536

Fax

(610) 660-9219

NPI assigned

Dec 17, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1166313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740343409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 COULTER AVE",
            "city": "ARDMORE",
            "state": "PA",
            "postal_code": "190032427",
            "telephone_number": "610-896-7536",
            "fax_number": "610-660-9219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 COULTER AVE",
            "city": "ARDMORE",
            "state": "PA",
            "postal_code": "190032427",
            "telephone_number": "610-896-7536",
            "fax_number": "610-660-9219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS004221L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kayla Martin, PT, DPT
• Mary Ann Catherine Marzen, LCSW
• Kenneth Thomas Mason Jr., PA-C
• Shannon Marie Mastin, M.S.P.T
• Megan Matusky, LCSW
• Carolina Maya Lopera, MD

• Psychologist in Ardmore, PA
• Providers in Ardmore, PA by specialty
• Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.