Individual provider Active NPI

Martha Jayne Huckins, LCMHC, MLADC

  • Addiction (Substance Use Disorder) Counselor
  • Keene, NH
National Provider Identifier
1841530367
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
0871 Issued in NH
Practice address
103 Roxbury St
Suite 206
Keene, NH 03431
Phone
(603) 903-5643
Fax
(603) 338-0332
NPI assigned
Feb 20, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 1978 NH
Addiction (Substance Use Disorder) Counselor 101YA0400X 0871 NH Primary

Addresses

Primary practice location

103 Roxbury St
Suite 206
Keene, NH 03431

Mailing address

103 Roxbury St
Suite 206
Keene, NH 03431
Phone (603) 903-5643

Other practice location 1

40 Avon St
Keene, NH 03431-3516
Phone (603) 357-4400 ext. 410

Other identifiers 1

IdentifierTypeStateIssuer
3106784MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20240226001796 NH Practitioner - Mental Health Counselor 2567836786 Reassigns benefits to 1 organization
Practice locations: Keene, NH

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

103 Roxbury St
Suite 206
Keene, NH 03431-3800
Phone (603) 903-5643

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0871NHMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Monadnock Family Services CurrentSince Jan 1, 2024 Accepting new patients

Locations

40 Avon St
Keene, NH 03431
Phone (603) 352-1024

64 Main St
Ste 301
Keene, NH 03431
Phone (603) 357-6878

64 Main St
Fl 2
Keene, NH 03431

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": "1361318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1841530367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 ROXBURY ST",
            "address_2": "SUITE 206",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "03431",
            "telephone_number": "603-903-5643",
            "fax_number": "603-338-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 ROXBURY ST",
            "address_2": "SUITE 206",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "03431",
            "telephone_number": "603-903-5643",
            "fax_number": "603-338-0332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Avon St",
            "address_purpose": "LOCATION",
            "city": "Keene",
            "state": "NH",
            "postal_code": "034313516",
            "country_code": "US",
            "telephone_number": "603-357-4400 x410",
            "fax_number": "603-953-0926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUCKINS",
        "first_name": "MARTHA",
        "middle_name": "JAYNE",
        "name_prefix": "Mrs.",
        "credential": "LCMHC, MLADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-20",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NH",
            "license": "1978",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NH",
            "license": "0871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3106784",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Keene, NH

Sources for this page

Verify at the official NPI Registry.