Individual provider Active NPI

Jacqueline Martinez, LPC

  • Mental Health Counselor
  • Aurora, CO
National Provider Identifier
1740682574
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC.0017671 Issued in CO
Practice address
1290 Chambers Rd
Aurora, CO 80011-7117
Phone
(303) 617-2300
Fax
(303) 617-2344
NPI assigned
Sep 24, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC.0017671 CO Primary

Addresses

Primary practice location

1290 Chambers Rd
Aurora, CO 80011-7117

Mailing address

3871 S Dallas St
Aurora, CO 80014-7452
Phone (407) 965-6443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20240125001741 CO Practitioner - Mental Health Counselor 6800249954 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC.0017671COMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Comprehensive Community Mental Health Center, Inc CurrentSince Jan 1, 2024 Accepting new patients
Aurora Comprehensive Community Mental Health Center, Inc CurrentSince Jan 1, 2024 Accepting new patients
Aurora Comprehensive Community Mental Health Center Past Accepting new patients

Locations

14301 E Hampden Ave
Aurora, CO 80014
Phone (303) 617-2600

1290 Chambers Rd
Aurora, CO 80011
Phone (303) 617-2715

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1740682574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3871 S DALLAS ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800147452",
            "telephone_number": "407-965-6443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 CHAMBERS RD",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800117117",
            "telephone_number": "303-617-2300",
            "fax_number": "303-617-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "JACQUELINE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-24",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPC.0017671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.