Active NPI
Charles Robert Martin, LMFT LMHC NCC
- Marriage & Family Therapist
- Evansville, IN
National Provider Identifier
1790941557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 35000349A
- Practice address
- 613 Cherry St
St Marys Ministry Center
Evansville, IN 47713-1807 - Phone
- (812) 425-1577
- Fax
- (812) 426-1416
- NPI assigned
- Jul 31, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39000879A | IN | |
| Marriage & Family Therapist | 106H00000X | 35000349A | IN | Primary |
Addresses
Primary practice location
613 Cherry St
St Marys Ministry Center
Evansville, IN 47713-1807
Mailing address
613 Cherry St
St Marys Ministry Center
Evansville, IN 47713-1807
Phone (812) 425-1577
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
| License | State | Type | Specialty |
|---|---|---|---|
| 39000879A | IN | MD | Mental Health Counselor |
| 35000349A | IN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217462400000",
"number": "1790941557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "613 CHERRY ST",
"address_2": "ST MARYS MINISTRY CENTER",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477131807",
"telephone_number": "812-425-1577",
"fax_number": "812-426-1416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "613 CHERRY ST",
"address_2": "ST MARYS MINISTRY CENTER",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477131807",
"telephone_number": "812-425-1577",
"fax_number": "812-426-1416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "CHARLES",
"middle_name": "ROBERT",
"name_prefix": "Mr.",
"credential": "LMFT LMHC NCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-31",
"last_updated": "2008-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39000879A",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IN",
"license": "35000349A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.