Kenneth Noel Martin, MA, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

178.015534 Issued in IL

Practice address

616 Iaa Dr
Bloomington, IL 61701-2225

Phone

(309) 838-7777

NPI assigned

Jan 3, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Compass Counselors LTD.

  • Physician Assistant
  • Bloomington, IL
  • NPI 1225912231
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1578009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1861031148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2509 SLAYTON DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043627",
            "telephone_number": "309-838-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 IAA DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617012225",
            "telephone_number": "309-838-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KENNETH",
        "middle_name": "NOEL",
        "name_prefix": "Mr.",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-03",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.015534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerri Marsh, LCPC
• Jalyn L Marshall
• Kimberly Diana Martin-Corcoran
• Alyssa Julianna Martin
• Ann K Martin, DPT
• Mark Randall Martin, L.C.P.C.
• William M Martin, R.PH.
• Polly Sue Masemore, PT
• Masengale Counseling, PLLC
• Kenneth B Masi, PHD,

• Mental Health Counselor in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.