Individual provider Active NPI

Amanda Jo Martinez, MA, LPC

  • Counseling Psychologist
  • Kalamazoo, MI
National Provider Identifier
1760370548
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
6401223641 Issued in MI
Practice address
1090 N 10TH St
Kalamazoo, MI 49009-5733
Phone
(269) 375-4363
Fax
(269) 375-4362
NPI assigned
Jun 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 6401223641 MI Primary

Addresses

Primary practice location

1090 N 10TH St
Kalamazoo, MI 49009-5733

Mailing address

1090 N 10TH St
Kalamazoo, MI 49009-5733
Phone (269) 375-4363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20250926003112 MI Practitioner - Mental Health Counselor 6305341579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1090 N 10TH St
Kalamazoo, MI 49009-5733

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Christian Counseling PC Professional CurrentSince Jul 20, 2025 Accepting new patients

Locations

2425 S 11th St
Ste A
Kalamazoo, MI 49009
Phone (269) 375-4363

1090 N 10th St
Ste 110
Kalamazoo, MI 49009
Phone (269) 375-4363

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1750982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1760370548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 N 10TH ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490095733",
            "telephone_number": "269-375-4363",
            "fax_number": "269-375-4362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 N 10TH ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490095733",
            "telephone_number": "269-375-4363",
            "fax_number": "269-375-4362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "AMANDA",
        "middle_name": "JO",
        "name_prefix": "Miss",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-27",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6401223641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.