Active NPI
Amy R Martin, LPC
- Professional Counselor
- Fredericksburg, VA
National Provider Identifier
1841505393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LCPC2428
- Practice address
- 1380 Central Park Blvd Ste 204
Fredericksburg, VA 22401-4926 - Phone
- (540) 602-2545
- NPI assigned
- Aug 9, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | |||
| Professional Counselor | 101YP2500X | P1312113 | AR | |
| Professional Counselor | 101YP2500X | LCPC2428 | KS | Primary |
Addresses
Primary practice location
1380 Central Park Blvd Ste 204
Fredericksburg, VA 22401-4926
Mailing address
334 Garfield CT
Fredericksburg, VA 22408-1919
Phone (501) 650-6333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201120830A | Medicaid | KS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1380 Central Park Blvd
Fredericksburg, VA 22401-4926
Phone (540) 602-2545
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P1312113 | AR | MD | Professional Counselor |
| LCPC2428 | KS | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revelations Counseling & Consulting, LLC | Current | Accepting new patients |
Locations
1380 Central Park Blvd
Ste 205
Fredericksburg, VA 22401
Phone (540) 602-2545
1380 Central Park Blvd
Ste 204
Fredericksburg, VA 22401
Phone (540) 602-2545
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.
-
- Community/Behavioral Health Agency
- Fredericksburg, VA
- NPI 1275813347
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754438400000",
"number": "1841505393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "334 GARFIELD CT",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224081919",
"telephone_number": "501-650-6333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1380 CENTRAL PARK BLVD STE 204",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224014926",
"telephone_number": "540-602-2545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "AMY",
"middle_name": "R",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-09",
"last_updated": "2025-08-06",
"certification_date": "2025-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AR",
"license": "P1312113",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "KS",
"license": "LCPC2428",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201120830A",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fredericksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.