Individual provider Active NPI

Stephanie Anne Martinez, LGMFT

  • Marriage & Family Therapist
  • Bethesda, MD
National Provider Identifier
1861047821
Registry record updated Aug 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LGM738 Issued in MD
Practice address
5652 Shields Dr
Bethesda, MD 20817-3574
Phone
(240) 225-0522
NPI assigned
Aug 7, 2019
Last updated
Aug 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LGM738 MD Primary

Addresses

Primary practice location

5652 Shields Dr
Bethesda, MD 20817-3574

Mailing address

1021 N Garfield St Apt 442
Arlington, VA 22201-2565
Phone (915) 346-6779

Other identifiers 1

IdentifierTypeStateIssuer
1386161305OtherCAREFIRST BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LGM738MDMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1861047821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 N GARFIELD ST APT 442",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222012565",
            "telephone_number": "915-346-6779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5652 SHIELDS DR",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208173574",
            "telephone_number": "240-225-0522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "STEPHANIE",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "LGMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-07",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MD",
            "license": "LGM738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "1386161305",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.