Jennie P Martin, LAC

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

A0810076 Issued in AR

Practice address

130 Spring St
Springdale, AR 72764-4567

Phone

(479) 751-5704

Fax

(479) 750-7050

NPI assigned

Oct 20, 2009

Sex

Female

Sole proprietor

Yes

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

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.

• Northwest Arkansas Counseling Inc

  • Counselor
  • Springdale, AR
  • NPI 1073722344
  NPD (past)
• Nwaci

  • Adult Mental Health Clinic/Center
  • Springdale, AR
  • NPI 1184773178
  NPD (past)

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255996800000",
    "number": "1912233370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 PINE MEADOW DR",
            "city": "FARMINGTON",
            "state": "AR",
            "postal_code": "727308624",
            "telephone_number": "479-267-0268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 SPRING ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727644567",
            "telephone_number": "479-751-5704",
            "fax_number": "479-750-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JENNIE",
        "middle_name": "P",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-20",
        "last_updated": "2009-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "AR",
            "license": "A0810076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Lemuel Martin, MHPP
• Andrew Arthur Martin, MD
• Connie Ann Martin, LPC LMFT
• Fredrick Allan Martin, M.D.
• Heron B Martin, APRN
• Kyndall Grace Martin, M.D.
• Matthew Martin
• Sara Vanessa Martin
• Heather Ann Martinelli, MD
• Alyah Martinez

• Community Health Worker in Springdale, AR
• Providers in Springdale, AR by specialty
• Community Health Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; 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.