Stacy Martin, MA, BCBA, COBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

882 Eastchester Dr
Gahanna, OH 43230-5137

Phone

(919) 771-3930

NPI assigned

Jun 25, 2007

Last updated

Jul 19, 2023By the provider in NPPES

Sex

Female

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

Credentials

Master of Arts

Practice roles

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.

• Stacy Martin, LLC

  • Community/Behavioral Health Agency
  • Gahanna, OH
  • NPI 1174076699
  NPD (past) Authorized official

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1760688907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "882 EASTCHESTER DR",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432305137",
            "telephone_number": "919-771-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "882 EASTCHESTER DR",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432305137",
            "telephone_number": "919-771-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "STACY",
        "credential": "MA, BCBA, COBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin J Martin, MD
• Kevin Douglas Martin, DO
• Krystal L Martin, LISW
• Mindy Martin, PTA
• Robert A. Martin, M.D.
• Xavier Stephen Martinez, DPT
• Brock Alexander Mason, DPT, PT
• Candaysha Mason, CARE MANAGER
• Janet Rae Mason, MD
• Francine Matteson, MS, R.D., L.D.

• Behavior Analyst in Gahanna, OH
• Providers in Gahanna, OH by specialty
• Behavior Analyst in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.