Individual provider Active NPI

Jessica Martinez, MA, LPC-S

  • Professional Counselor
  • Dallas, TX
National Provider Identifier
1790199040
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
69555 Issued in TX
Practice address
8111 Lyndon B Johnson Fwy Ste 900
Dallas, TX 75251-1322
Phone
(800) 241-8716
Fax
(469) 972-0031
NPI assigned
Jun 15, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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 69555 TX Primary

Addresses

Primary practice location

8111 Lyndon B Johnson Fwy Ste 900
Dallas, TX 75251-1322

Mailing address

4490 Nancy LN
Midlothian, TX 76065-4528
Phone (469) 245-6069

Other practice location 1

4490 Nancy Ln
Midlothian, TX 76065-4528
Phone (469) 245-6069

Other practice location 2

3001 Al Lipscomb Way
Dallas, TX 75215-1702
Phone (800) 241-8716

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
69555TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
North Texas Behavioral Health Authority Professional CurrentSince Oct 29, 2023 Accepting new patients

Locations

8111 Lyndon B Johnson Fwy
Ste 900
Dallas, TX 75251
Phone (214) 366-9407

3001 Al Lipscomb Way
Dallas, TX 75215
Phone (214) 366-9407

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": "1402790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1790199040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4490 NANCY LN",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760654528",
            "telephone_number": "469-245-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8111 LYNDON B JOHNSON FWY STE 900",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752511322",
            "telephone_number": "800-241-8716",
            "fax_number": "469-972-0031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4490 Nancy Ln",
            "address_purpose": "LOCATION",
            "city": "Midlothian",
            "state": "TX",
            "postal_code": "760654528",
            "country_code": "US",
            "telephone_number": "469-245-6069",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3001 Al Lipscomb Way",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752151702",
            "country_code": "US",
            "telephone_number": "800-241-8716",
            "fax_number": "469-972-0031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "JESSICA",
        "credential": "MA, LPC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-15",
        "last_updated": "2023-10-24",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "69555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.