Individual provider Active NPI

Amy R Martin, LPC

  • Professional Counselor
  • Fredericksburg, VA
National Provider Identifier
1841505393
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LCPC2428 Issued in KS
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

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
201120830AMedicaidKS

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260427000077 VA Practitioner - Mental Health Counselor 8426525585 Reassigns benefits to 1 organization

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
Revelations Counseling and Consulting, LLCGroup PAC ID 3971774209, 4 clinicians

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

LicenseStateTypeSpecialty
P1312113ARMDProfessional Counselor
LCPC2428KSMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Revelations Counseling & Consulting, LLC CurrentSince Aug 10, 2025 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.

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

Verify at the official NPI Registry.