Individual provider Active NPI

Ambrocia Martin

  • Professional Counselor
  • Philadelphia, PA
National Provider Identifier
1750889994
Registry record updated Jan 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC008909 Issued in PA
Practice address
2043 Eastburn Ave
Philadelphia, PA 19138-2636
Phone
(215) 460-9005
NPI assigned
Jan 23, 2018
Last updated
Jan 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC008909 PA Primary

Addresses

Primary practice location

2043 Eastburn Ave
Philadelphia, PA 19138-2636

Mailing address

621 Croyden Rd
Cheltenham, PA 19012-1615
Phone (267) 226-5393

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PC008909PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerment Counseling Services Professional CurrentSince Nov 26, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516665600000",
    "number": "1750889994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 CROYDEN RD",
            "city": "CHELTENHAM",
            "state": "PA",
            "postal_code": "190121615",
            "telephone_number": "267-226-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2043 EASTBURN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191382636",
            "telephone_number": "215-460-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "AMBROCIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-23",
        "last_updated": "2018-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC008909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2018; 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.