Antonio Lavelle Darshie Martin

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

527 SE Morrison St
Portland, OR 97214-2300

Phone

(503) 501-5294

NPI assigned

Dec 18, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1576627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1760020994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8915 SW CENTER ST",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236307",
            "telephone_number": "503-726-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 SE MORRISON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142300",
            "telephone_number": "503-501-5294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ANTONIO",
        "middle_name": "LAVELLE DARSHIE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-18",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glaucia Martin-Porath
• Alex James Martin
• Andrea Martin, MSPT
• Andrea Michelle Martin, M.A.
• Ann Marie Martin, LCSW
• Ashley Martin
• Austin Douglas Martin, MA
• Barbara Elizabeth Martin, PA
• Benjamin Carlos Martin, LMT
• Brennen Mitchell Martin

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; 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.