Destin Rae Martini, SUDP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CO61210725 Issued in WA

Practice address

500 SE Washington Ave
Chehalis, WA 98532-3058

Phone

(360) 748-4776

NPI assigned

Jan 27, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Hope and Healing Clinic LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tumwater, WA
  • NPI 1376336974
  NPD
• Hope and Healing Clinic LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Tumwater, WA
  • NPI 1669258133
  NPD

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

{
    "created_epoch": "1643241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1902559222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9474 LATHROP INDUSTRIAL DR SW",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985121109",
            "telephone_number": "360-583-3340",
            "fax_number": "360-322-3804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SE WASHINGTON AVE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985323058",
            "telephone_number": "360-748-4776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINI",
        "first_name": "DESTIN",
        "middle_name": "RAE",
        "credential": "SUDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-27",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO61210725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2077844",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Marsyla, REGISTERED NURSE
• Alexa Martin
• Kaylin Sheree Martin
• Taeya Aileene Martin
• Carlos Alberto Martinez, B.A.
• Joanne Marty
• Marys Corner Medical Clinic Inc PS
• Marys Corner Medical Clinic Inc. PS
• Massage by Cora Yoone PLLC
• Venus H Masters, LMHC

• Addiction (Substance Use Disorder) Counselor in Chehalis, WA
• Providers in Chehalis, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.